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首页> 外文期刊>Obstetrics and Gynecology: Journal of the American College of Obstetricians and Gynecologists >Cerebrovascular hemodynamics in pregnant women with mild chronic hypertension.
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Cerebrovascular hemodynamics in pregnant women with mild chronic hypertension.

机译：轻度慢性高血压孕妇的脑血管血流动力学。

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OBJECTIVE: To evaluate and compare the cerebrovascular autoregulation in pregnant normotensive and mild chronic hypertensive patients without preeclampsia. METHODS: Transcranial Doppler ultrasound was used to measure peak, end-diastolic, and mean velocities in the middle cerebral arteries of 34 normotensive and 17 mild chronic hypertensive women in the third trimester of pregnancy. Measurements were performed in the left lateral position at baseline, during 5% CO(2) inhalation, and during an isometric handgrip test. Mean pulsatility index, resistance index, and cerebral perfusion pressure at each time were compared using 2-way repeated measures analysis of variance. Using an alpha error of 5%, the statistical power to identify differences in middle cerebral artery indices in response to the two maneuvers was at least 90% and 50% in comparison between the two groups. Significance was P <.05. RESULTS: Pregnant women with mild chronic hypertension had higher baseline mean blood pressure but similar pulsatility index (0.73 versus 0.75), resistance index (0.50 versus 0.50), and cerebral perfusion pressure (59.9 versus 61.8 mm Hg) compared with normotensive pregnant women. Both maneuvers caused a significant reduction in pulsatility index and resistance index and higher cerebral perfusion pressure. No significant differences were noted in the response to either 5% CO(2) inhalation or isometric handgrip test between the two groups. CONCLUSION: Pregnant women with mild chronic hypertension show normal cerebral vasomotor reactivity to CO(2) breathing and isometric handgrip. This suggests that the abnormal cerebrovascular autoregulation in preeclampsia is not directly linked to the elevated blood pressure but rather is determined by a separate pathophysiologic pathway. LEVEL OF EVIDENCE: II-2
机译：目的：评估和比较未先兆子痫的孕妇正常血压和轻度慢性高血压患者的脑血管自动调节。方法：经颅多普勒超声用于测量妊娠中期三个34位血压正常和17位轻度慢性高血压妇女的大脑中动脉峰值，舒张末期和平均速度。在基线，5％CO（2）吸入期间和等距手柄测试期间，在左侧位置进行测量。使用2次重复测量方差分析比较每次的平均搏动指数，阻力指数和脑灌注压力。使用5％的alpha误差，与两组相比，识别响应于这两种操作的大脑中动脉指数差异的统计功效至少为90％和50％。显着性为P <.05。结果：与正常血压的孕妇相比，轻度慢性高血压的孕妇基线平均血压较高，但搏动指数（0.73对0.75），抵抗指数（0.50对0.50）和脑灌注压（59.9对61.8 mm Hg）相似。两种操作均导致搏动指数和阻力指数显着降低，并导致较高的脑灌注压力。两组之间对5％CO（2）吸入或等距手柄测试的反应均未发现明显差异。结论：轻度慢性高血压孕妇表现出正常的脑血管舒缩反应到CO（2）呼吸和等距把手。这表明先兆子痫中异常的脑血管自动调节并不与血压升高直接相关，而是由单独的病理生理途径确定的。证据级别：II-2

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