Association Of Renal Doppler Velocimetry Change With Endothelia Dysfunction And Hypertensive Disorder Complicating Pregnancy

Objective:To determine if there are differences among the level of intrarenal artery blood flow parameters,endothelin-l,nitric oxide, blood fat in normal pregnancy women and the patients of hypertensive disorder complication pregnancy. The purpose of the examination is to investigate the endothelin-1, nitric oxide, blood fat may be can affect the function of endotheliocytes and renal artery blood flow, and to explore the clinical value of intrarenal artery blood flow change in hypertensive disorder complication pregnancy.Methods:18 patients of gestational hypertension,18 patients of gently preeclampsia, 20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random. Color ultrasonography was used to detect the velocity PI,RI, peak systolic velocity (PSV), end diastolic velocity(EDV) and S/D,PI,RI values of renal artery.The levels of plasma ET-1 and serum oxLDL were measured by enzyme_linked immunosorbent assay (ELISA). The level of NO in serum is surveyed by the method of nitric acid recovery. The levels of blood fat and renal function are measured by enzymic method.Results:The level of renal artery blood flow parameters:The level of EDV are conspicuous lower in preeclampsia patients than the normal gravidas (P<0.05). But the level of RI,PI,S/D in preeclampsia patients are conspicuous higher than the control group(P<0.05). The difference between the gestational hypertension group and the control group is not significant.1. The level of blood fat:the level of TG, TC, LDL, VLDL and oxLDL are conspicuous higher in hypertensive patients than the normal gravidas (P<0.01). But the level of HDL in case group is conspicuous lower than the control group. The difference between the case groups is significant (P<0.01).2. The level of ET-1 in case group is higher than control group. The level of ET-1 is higher, the illness is severe.3. The level of NO is lower in case group than the normal gravidas. The level of NO is lower, the illness is severe.4. The level of blood urea nitrogen (BUN), creatinine (Cr), uric acid (UA) in case group is higher than control group (P<0.05). The difference between the gestational hypertension group and preeclampsia group is significant (P<0.05). 6. There is positive correlation between the S/D,RI,PI and the level of serum ET-1(r=0.737,0.570,0.670;P<0.01), There is positive correlation between the S/D, RI,PI and the level of serum oxLDL(r=0.771,0.724,0.752; P<0.01).But There is inverse correlation between the S/D,RI,PI and level of serum NO(r=-0.843,-0.749,-0.793; P<0.01). There is positive correlation between the RI,PI and level of serum BUN,Cr,UA((r=0.543,0.545,0.533; r=0.551,0.481,0.493;均P<0.01); oxLDL and ET-1 have positive correlation(r=0.710; P<0.01),oxLDL and NO have inverse correlation(r=-0.795; P<0.01).Conclusions:The level of renal artery blood flow resistance in hypertensive disorder complication pregnancy is gradually increase, blood flow velocity is gradually decrease, especially EDV is more lower.The level of renal artery RI,PI,S/D is higher and PSV, EDV is lower, the illness is severe. And when the level of ET-1,oxLDL is higher, the disease is more severe, the level of NO is lower, the disease is more severe. Endothelial dysfunction can cause unbalance of vessel systolic- diastolic function. The level of renal artery blood flow parameters can reflect the state of vessel function, the above-mentioned index of detecting has important clinical value in predicting and accessing hypertensive disorder complication pregnancy.