Objective: To analyze the correlation between the vascular endothelial function (characterized by endothelin-1 and nitric oxide) and the renal hemodynamics in patients with hypertensive disorders in pregnancy (HDP) by color Doppler ultrasound.
Method: Depending on the severity of the disease, 76 HDP patients were divided into three groups, namely, pregnancy-induced hypertension (PIH) group (n=26), mild preeclampsia (PE) group (n=28), and severe PE group (n=22). In the meantime, 28 healthy pregnant women were selected as controls. Color Doppler ultrasound was performed to determine the following parameters in the interlobar arteries of the kidney: Resistance index (RI), peak end-diastolic velocity (EDV), pulsatility index (PI), peak systolic velocity (PSV), and S/D ratio. The correlations of these parameters with the serum levels of ET-1 and NO were then analyzed.
Result: (1) In the interlobar arteries of the kidney, RI, S/D, PI were positively significantly correlated to the serum level of ET-1 in HDP patients (All p<0.001) and negatively to the serum level of NO (All p<0.01). (2) RI, S/D, PI of the mild and severe PE groups were significantly higher than those of the control group (All p<0.05). However, EDV of the mild and severe PE groups was significantly lower than that of the control group (All p<0.05). (3) The serum level of ET-1 was significantly higher in the HDP patients than in the control group (p<0.001). However, the serum level of NO was significantly lower in the former than in the latter (p<0.001). As HDP became more severe, there was an elevation in the serum level of ET-1 and a decrease in NO.
Conclusion: Indicators of renal hemodynamics measured by color Doppler ultrasound were correlated to the serum levels of ET-1 and NO characterizing the vascular endothelial function. They were sensitive indicators reflecting hemodynamic changes and renal impairment in HDP patients.