上海交通大学学报(医学版) ›› 2024, Vol. 44 ›› Issue (5): 543-551.doi: 10.3969/j.issn.1674-8115.2024.05.001
• 高危妊娠专题 •
马瑞琳1(), 刘雨1(), 徐桂香1, 史昊然1, 崔俭俭1, 杨泽俊1, 毛艳1, 赵茵1,2()
收稿日期:
2023-10-16
接受日期:
2024-03-04
出版日期:
2024-05-28
发布日期:
2024-05-28
通讯作者:
赵茵
E-mail:maruilin202076100@163.com;lyu_9618@126. com;Zhaoyin@hust.edu.cn
作者简介:
马瑞琳(1997—),女,博士生;电子信箱:maruilin202076100@163.com基金资助:
MA Ruilin1(), LIU Yu1(), XU Guixiang1, SHI Haoran1, CUI Jianjian1, YANG Zejun1, MAO Yan1, ZHAO Yin1,2()
Received:
2023-10-16
Accepted:
2024-03-04
Online:
2024-05-28
Published:
2024-05-28
Contact:
ZHAO Yin
E-mail:maruilin202076100@163.com;lyu_9618@126. com;Zhaoyin@hust.edu.cn
Supported by:
摘要:
目的·通过超声多普勒检测子痫前期(preeclampsia,PE)大鼠模型子宫动脉、脐动脉、大脑中动脉参数,对比胎盘血管病理及妊娠结局,为评估PE动物模型胎盘功能提供有效方法和参考。方法·利用N-硝基-L-精氨酸甲酯(N′-nitro-L-arginine-methylesterhydrochloride,L-NAME)和0.9%氯化钠溶液腹腔注射,分别建立PE组(n=8)和正常妊娠(normal pregnancy,NP)组(n=8)的SD大鼠动物模型,检测血压和蛋白尿指标评估模型是否成功建立。在妊娠(gestational day,GD)第19日(GD19)时利用超声多普勒检测PE组和NP组子宫动脉、脐动脉以及胎鼠大脑中动脉相关指标,终止妊娠后通过胎盘血管病理、胎鼠胎盘质量情况评估胎盘功能。结果·PE组大鼠的血压(GD15:P=0.001;GD19:P=0.001)、蛋白尿(GD15:P=0.001;GD19:P=0.001)均高于NP组,其胎鼠脐动脉、子宫动脉的搏动指数(pulsation index,PI)显著高于NP组(均P=0.000),胎鼠大脑中动脉阻力指数(resistance index,RI)显著低于NP组(P=0.000)。胎鼠数量无显著差异,PE组胎盘、胎鼠质量显著低于NP组(P=0.006,P=0.000),胎盘组织血管特异性免疫组化染色提示PE组胎盘微血管迷路密度少于NP组(P=0.001)。通过相关性分析发现胎盘微血管迷路密度、胎鼠质量、胎盘质量与脐动脉RI、子宫动脉PI及RI呈负相关,而与大脑中动脉S/D、PI、RI呈正相关(均P<0.05)。结论·超声多普勒检测L-NAME诱导的PE大鼠模型子宫动脉、脐动脉、大脑中动脉指数相关指标可以良好反映妊娠结局和胎盘血管病理情况,可用于评价PE大鼠模型的胎盘血管灌注情况,具有动物模型研究的实用性和便利性。
中图分类号:
马瑞琳, 刘雨, 徐桂香, 史昊然, 崔俭俭, 杨泽俊, 毛艳, 赵茵. 子痫前期大鼠模型子宫动脉、脐动脉、大脑中动脉超声多普勒参数与胎盘血管病理及妊娠结局的关系[J]. 上海交通大学学报(医学版), 2024, 44(5): 543-551.
MA Ruilin, LIU Yu, XU Guixiang, SHI Haoran, CUI Jianjian, YANG Zejun, MAO Yan, ZHAO Yin. Relationship between Doppler ultrasound parameters of uterine artery, umbilical artery, middle cerebral artery and placental vasculopathology and pregnancy outcome in preeclampsia rat model[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(5): 543-551.
图1 SD大鼠脐动脉、大脑中动脉、子宫动脉的超声成像Note: A. Umbilical artery. Small arrow—fetal rat, large arrow—umbilical cord. B. Middle cerebral artery. Small arrow—fetal rat head, large arrow—middle cerebral artery. C. Uterine artery. Small arrow—lateral edge of the rat uterus, large arrow—uterine artery.
Fig 1 Ultrasound imaging of the umbilical artery, middle cerebral artery and uterine artery in SD rats
Item | |||
---|---|---|---|
表1 2组尾动脉血压及尿蛋白比较
Tab 1 Comparison of tail artery blood pressure and urinary protein between the two groups
Item | |||
---|---|---|---|
Item | NP | PE | P value |
---|---|---|---|
7.05±1.51 | 10.51±2.74 | 0.008 | |
2.08±0.78 | 1.59±0.71 | 0.203 | |
4.26±0.94 | 5.25±1.16 | 0.083 | |
3.61±0.97 | 13.95±18.00 | 0.127 | |
1.18±0.16 | 1.72±0.13 | 0.000 | |
0.71±0.07 | 0.88±0.06 | 0.000 |
表2 超声评价2组胎鼠脐动脉血流动力学的比较
Tab 2 Comparison of fetal umbilical artery hemodynamics using ultrasound evaluation between the two groups
Item | NP | PE | P value |
---|---|---|---|
7.05±1.51 | 10.51±2.74 | 0.008 | |
2.08±0.78 | 1.59±0.71 | 0.203 | |
4.26±0.94 | 5.25±1.16 | 0.083 | |
3.61±0.97 | 13.95±18.00 | 0.127 | |
1.18±0.16 | 1.72±0.13 | 0.000 | |
0.71±0.07 | 0.88±0.06 | 0.000 |
Item | NP group | PE group | P value |
---|---|---|---|
16.27±3.93 | 0.203 | ||
7.98±2.50 | 0.067 | ||
11.05±3.26 | 0.751 | ||
2.05±0.16 | 0.000 | ||
0.77±0.10 | 0.000 | ||
0.51±0.44 | 0.000 |
表3 超声评价2组子宫动脉血流动力学的比较
Tab 3 Comparison of uterine artery hemodynamics using ultrasound evaluation between the two groups
Item | NP group | PE group | P value |
---|---|---|---|
16.27±3.93 | 0.203 | ||
7.98±2.50 | 0.067 | ||
11.05±3.26 | 0.751 | ||
2.05±0.16 | 0.000 | ||
0.77±0.10 | 0.000 | ||
0.51±0.44 | 0.000 |
Item | NP | PE | P value |
---|---|---|---|
0.264 | |||
0.000 | |||
0.073 | |||
0.000 | |||
0.000 | |||
0.000 |
表4 超声评价2组胎鼠大脑中动脉血流动力学的比较
Tab 4 Comparison of fetal middle cerebral artery hemodynamics using ultrasound evaluation between the two groups
Item | NP | PE | P value |
---|---|---|---|
0.264 | |||
0.000 | |||
0.073 | |||
0.000 | |||
0.000 | |||
0.000 |
Item | NP group | PE group | P value |
---|---|---|---|
Placental quality/ | 0.006 | ||
Fetal rat quality/ | 4.20 | 0.000 | |
Fetal number/n | 0.526 |
表5 2组胎盘质量和胎鼠数量、质量比较
Tab 5 Comparison of placental quality, fetal rat number and fetal rat quality between the two groups
Item | NP group | PE group | P value |
---|---|---|---|
Placental quality/ | 0.006 | ||
Fetal rat quality/ | 4.20 | 0.000 | |
Fetal number/n | 0.526 |
P value | |||
---|---|---|---|
表6 2组MVD比较
Tab 6 Comparison of MVD between the two groups
P value | |||
---|---|---|---|
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.657 (0.006) | -0.160 (0.554) | -0.638 (0.008) |
ED | 0.304 (0.253) | 0.522 (0.038) | 0.354 (0.178) |
TAV | -0.466 (0.069) | -0.182 (0.500) | -0.424 (0.102) |
S/D | -0.284 (0.287) | -0.698 (0.003) | -0.353 (0.179) |
PI | -0.850 (0.000) | -0.450 (0.081) | -0.901 (0.000) |
RI | -0.758 (0.001) | -0.740 (0.001) | -0.832 (0.000) |
表7 脐动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD的相关性分析[r (P)]
Tab 7 Correlation analysis between umbilical artery parameters and placental quality, fetal rat quality and placental MVD [r (P)]
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.657 (0.006) | -0.160 (0.554) | -0.638 (0.008) |
ED | 0.304 (0.253) | 0.522 (0.038) | 0.354 (0.178) |
TAV | -0.466 (0.069) | -0.182 (0.500) | -0.424 (0.102) |
S/D | -0.284 (0.287) | -0.698 (0.003) | -0.353 (0.179) |
PI | -0.850 (0.000) | -0.450 (0.081) | -0.901 (0.000) |
RI | -0.758 (0.001) | -0.740 (0.001) | -0.832 (0.000) |
图4 脐动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD相关性分析热图Note: Each number in the cells represents a correlation coefficient, with the depth of color indicating the magnitude of the value.
Fig 4 Heatmap of the correlation analysis between umbilical artery parameter indices and placental quality, fetal rat quality and placental MVD
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.332 (0.209) | -0.381 (0.145) | -0.302 (0.256) |
ED | 0.447 (0.083) | 0.291 (0.274) | 0.487 (0.056) |
TAV | 0.078 (0.775) | -0.061 (0.824) | 0.123 (0.650) |
S/D | -0.871 (0.000) | -0.638 (0.008) | -0.870 (0.000) |
PI | -0.892 (0.000) | -0.615 (0.011) | -0.922 (0.000) |
RI | -0.874 (0.000) | -0.621 (0.010) | -0.902 (0.000) |
表8 子宫动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD的相关性分析[r (P)]
Tab 8 Correlation analysis between uterine artery parameters and placental quality, fetal rat quality and placental MVD [r (P)]
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.332 (0.209) | -0.381 (0.145) | -0.302 (0.256) |
ED | 0.447 (0.083) | 0.291 (0.274) | 0.487 (0.056) |
TAV | 0.078 (0.775) | -0.061 (0.824) | 0.123 (0.650) |
S/D | -0.871 (0.000) | -0.638 (0.008) | -0.870 (0.000) |
PI | -0.892 (0.000) | -0.615 (0.011) | -0.922 (0.000) |
RI | -0.874 (0.000) | -0.621 (0.010) | -0.902 (0.000) |
图5 子宫动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD相关性分析热图Note: Each number in the cells represents a correlation coefficient, with the depth of color indicating the magnitude of the value.
Fig 5 Heatmap of the correlation analysis between uterine artery parameter indices and placental quality, fetal rat quality and placental MVD
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.148 (0.586) | -0.196 (0.467) | -0.300 (0.260) |
ED | -0.749 (0.001) | -0.575 (0.020) | -0.802 (0.000) |
TAV | -0.333 (0.207) | -0.342 (0.195) | -0.451 (0.079) |
S/D | 0.923 (0.000) | 0.582 (0.018) | 0.915 (0.000) |
PI | 0.895 (0.000) | 0.571 (0.021) | 0.850 (0.000) |
RI | 0.914 (0.000) | 0.569 (0.022) | 0.888 (0.000) |
表9 大脑中动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD的相关系数
Tab 9 Correlation coefficients between middle cerebral artery parameters and placental quality, fetal rat quality, and placental MVD
Item | MVD | Placental quality | Fetal rat quality |
---|---|---|---|
PS | -0.148 (0.586) | -0.196 (0.467) | -0.300 (0.260) |
ED | -0.749 (0.001) | -0.575 (0.020) | -0.802 (0.000) |
TAV | -0.333 (0.207) | -0.342 (0.195) | -0.451 (0.079) |
S/D | 0.923 (0.000) | 0.582 (0.018) | 0.915 (0.000) |
PI | 0.895 (0.000) | 0.571 (0.021) | 0.850 (0.000) |
RI | 0.914 (0.000) | 0.569 (0.022) | 0.888 (0.000) |
图6 大脑中动脉相关参数指标与胎盘质量、胎鼠质量及胎盘MVD相关性分析热图Note: Each number in the cells represents a correlation coefficient, with the depth of color indicating the magnitude of the value.
Fig 6 Heatmap of the correlation analysis between middle cerebral artery parameter indices and placental quality, fetal rat quality and placental MVD
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