Dickey R P, Hower J F
Louisiana State University School of Medicine, Department of Obstetrics and Gynecology, New Orleans, USA.
Early Pregnancy. 1996 Jun;2(2):113-20.
The purpose of this study was to examine the relationship of uterine blood flow to serum estradiol and progesterone during early pregnancy. Recumbent uterine artery average velocity, diameter, blood flow volume and uterine and spiral artery resistance were measured using vaginal Doppler ultrasound 118 times in 43 patients during gestational (postmenstrual) weeks 5 to 16. Relationships to serum progesterone and estrogen were analyzed before and after week 10, when intervillous circulation begins, by multiple linear regression analysis and analysis of covariance (ANCOVA) to correct for the effect of gestational age. After correction for gestational age, estradiol was negatively related to uterine artery flow volume (p < 0.05), diameter (p < 0.05), pulsatility index (p < 0.05) and resistance index (p < 0.01) for weeks 5-16 and to diameter (p < 0.05) after week 9. Progesterone was positively related to volume (p < 0.05) and velocity (p < 0.01) for weeks 5-16 and to volume (p < 0.05) for weeks 5 to 9. Spiral artery indices of resistance were unrelated to hormone levels. These results indicate that before the 10th gestational week, uterine blood flow volume is related to progesterone, but not estradiol levels, and suggest that high estradiol levels during and after the 10th week may be associated with decreased uterine blood flow volume.
本研究的目的是探讨妊娠早期子宫血流与血清雌二醇和孕酮之间的关系。在43例患者妊娠（月经后）第5至16周期间，使用阴道多普勒超声测量了118次卧位子宫动脉平均速度、直径、血流量以及子宫和螺旋动脉阻力。通过多元线性回归分析和协方差分析（ANCOVA）对胎龄的影响进行校正，分析了第10周（绒毛间隙循环开始时）前后与血清孕酮和雌激素的关系。校正胎龄后，在第5至16周期间，雌二醇与子宫动脉血流量（p<0.05）、直径（p<0.05）、搏动指数（p<0.05）和阻力指数（p<0.01）呈负相关，在第9周后与直径（p<0.05）呈负相关。在第5至16周期间，孕酮与血流量（p<0.05）和速度（p<0.01）呈正相关，在第5至9周期间与血流量（p<0.05）呈正相关。螺旋动脉阻力指数与激素水平无关。这些结果表明，在妊娠第10周之前，子宫血流量与孕酮有关，但与雌二醇水平无关，并提示第10周及之后雌二醇水平升高可能与子宫血流量减少有关。
