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目的了解胎儿宫内发育迟缓（ＩＵＧＲ）时胎盘病理改变与母血及脐血中一氧化氮（ＮＯ）水平的关系。方法对１９９７年１１月～１９９８年１０月３８例妊娠合并胎儿宫内发育迟缓（ＩＵＧＲ组）及３０例正常孕妇（对照组）分娩后的胎盘及胎儿附属物进行分析。用隔还原显色法测定母血及脐血ＮＯ水平。结果ＩＵＧＲ组中２６例有胎盘、脐带病理改变（６８．４２％）。主要表现为绒毛发育迟缓及绒毛炎；对照组中５例有胎盘病理改变（１６．６７％），两组比较差异有极显著性（Ｐ＜０．０１）；ＩＵＧＲ组中母血及脐血ＮＯ水平均低于对照组（Ｐ＜０．０５，Ｐ＜０．０１）；ＩＵＧＲ组中２６例胎盘病理改变明显，其母血及脐血ＮＯ水平低于胎盘无明显病理改变者（Ｐ＜０．０５，Ｐ＜０．０５）；两组脐血ＮＯ水平均高于母血ＮＯ水平（Ｐ＜０．０１，Ｐ＜０．０５），两组脐血与母血ＮＯ水平均有相关性（ｒ＝０．５４７５，ｒ＝０．８５０６）；脐血ＮＯ水平与新生儿体重在ＩＵＧＲ组未发现明显相关性（ｒ＝０．２８３８）。结论ＩＵＧＲ时，胎盘发生明显病理变化，导致母血及脐血中ＮＯ的水平降低。
Objective To investigate the relationship between placental pathological changes and nitric oxide (NO) levels in maternal blood and umbilical cord during intrauterine growth retardation (IUGR). Methods From November 1997 to October 1998, 38 cases of fetal intrauterine growth retardation (IUGR group) and 30 normal pregnant women (control group) were analyzed for placenta and fetal appendages after delivery. The level of NO in maternal blood and umbilical cord blood was determined by retro-assay. Results In the IUGR group, 26 cases had placenta and the umbilical cord pathological changes (68.42%). The main manifestations were villus growth retardation and villus inflammation; 5 cases of control group had pathological changes of placenta (16.67%), the difference between the two groups was significant (P <0.01); IUGR group of maternal blood and umbilical cord blood (P <0.05, P <0.01). The placenta pathological changes of 26 cases in IUGR group were obvious, the level of NO in maternal blood and cord blood was lower than that in placenta without significant pathological changes (P < 0.05, P <0.05). The levels of NO in both umbilical blood were higher than those in maternal blood (P <0.01, P <0.05) (R = 0.5475, r = 0.8506). There was no significant correlation between umbilical blood NO level and neonatal body weight in IUGR group (r = 0.2838). Conclusions IUGR, the placenta obvious pathological changes, resulting in maternal blood and cord blood levels of NO decreased.