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子痫前期预测和预防的研究进展

Latest Findings on Prediction and Prevention of Preeclampsia

  • 摘要: 子痫前期是一种妊娠期特有的多系统进展性疾病,严重影响母婴健康。目前研究发现该病始于子宫-胎盘供需不匹配,继而引起胎盘应激因子释放、血管/抗血管因子失衡,最终导致母体系统性内皮损伤、全身炎症反应。目前治疗子痫前期的手段有限,因此对其的预测、预防尤为重要。本文总结了近5年来子痫前期预测、预防方面的研究进展,肯定了基于胎盘源性血管生成因子(PlGF)的多变量模型筛查和阿司匹林、补钙、运动、提前终止妊娠等四种手段在预防子痫前期方面的作用,其他新的预防手段效果及安全性尚需进一步验证。

     

    Abstract: Preeclampsia, a progressive disease involving multiple systems, afflicts pregnancy specifically. It contributes to severe maternal and perinatal morbidity and mortality. It has been reported that preeclampsia initiates from a mismatch between the utero-placental supply and demand, which subsequently triggers the release of placental syncytiotrophoblast stress-derived factors and an imbalance of proangiogenic/antiangiogenic factors, eventually causing maternal systemic endothelial lesions and systemic inflammatory response. Currently, treatments available for preeclampsia are very limited in number. Hence, prediction and prevention carry special significance. Herein, we reviewed the current understanding of preeclampsia, especially findings on the prediction and prevention of preeclampsia published within the past 5 years. We discussed the Fetal Medicine Foundation (FMF) screening model based on placental growth factor (PlGF) and the effects of aspirin, calcium, exercise, and termination of pregnancy in preventing preeclampsia. The efficacy and safety of other new preventive measures still need further validation.

     

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