妊娠期高血压疾病的预防研究进展
Research Progress on Prevention of Hypertensive Disorders of Pregnancy
DOI: 10.12677/ACM.2023.1361360, PDF,   
作者: 王英梅：青海大学研究生院，青海 西宁；芦 莉*：青海省妇幼保健院妇产科，青海 西宁
关键词: 妊娠期高血压疾病；子痫前期；预防；Hypertensive Disorders of Pregnancy； Preeclampsia； Prevention
摘要: 妊娠期高血压疾病(Hypertensive Disorders of Pregnancy, HDP)是妊娠与血压升高并存的一组疾病，该组疾病包括妊娠期高血压，子痫前期，子痫，以及慢性高血压并发子痫前期和妊娠合并慢性高血压。HDP发生率5.2%~8.2%，是孕产妇和围产儿病死率升高的主要原因。子痫前期是HDP中最常见的，由于现阶段子痫前期的治疗方式有限，且危害较重，子痫前期的预防显得非常重要，并且近年来对预防这种疾病的兴趣以及对其病理生理学的更好理解导致了预防此疾病制剂的研究不断增加，本文综述了该疾病的主要病理生理学机制，并总结目前正在被用于子痫前期的预防或者有预防子痫前期潜力的药物及方法。
Abstract: Hypertensive Disorders of Pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. This group of diseases includes gestational hypertension, preeclampsia, ec-lampsia, and chronic hypertension complicated with preeclampsia and pregnancy with chronic hy-pertension. The incidence of HDP is 5.2%~8.2%, which is the main cause of maternal and perinatal mortality. Preeclampsia is the most common type of HDP. Due to the limited treatment of preeclampsia at this stage and the serious harm, the prevention of preeclampsia is very important. In recent years, the interest in preventing this disease and the better understanding of its patho-physiology have led to the prevention of this disease. The research on preparations is increasing. This article reviews the main pathophysiological mechanisms of the disease, and summarizes the drugs and methods that are currently being used for the prevention of preeclampsia or have the potential to prevent preeclampsia.
文章引用：王英梅, 芦莉. 妊娠期高血压疾病的预防研究进展[J]. 临床医学进展, 2023, 13(6): 9718-9723. https://doi.org/10.12677/ACM.2023.1361360

参考文献

[1] Ma’ayeh, M. and Costantine, M.M. (2020) Prevention of Preeclampsia. Seminars in Fetal and Neonatal Medicine, 25, Article ID: 101123. [Google Scholar] [CrossRef] [PubMed]
[2] Poniedziałek-Czajkowska, E., Mierzyński, R., Dłuski, D. and Leszczyńska-Gorzelak, B. (2021) Prevention of Hypertensive Disorders of Pregnancy—Is There a Place for Metformin? Journal of Clinical Medicine, 10, Article 2805. [Google Scholar] [CrossRef] [PubMed]
[3] Broughton, P.F. (2001) Risk Factors for Preeclampsia. The New Eng-land Journal of Medicine, 344, 925-926.
[4] Villar, J. and Belizán, J.M. (2000) Same Nutrient, Different Hypotheses: Disparities in Trials of Calcium Supplementation during Pregnancy. The American Journal of Clinical Nutrition, 71, 1375S-1379S. [Google Scholar] [CrossRef] 
[5] Hofmeyr, G., Atallah, A. and Duley, L. 2002) Calcium Supplementa-tion during Pregnancy for Preventing Hypertensive Disorders and Related Problems. In: Cochrane Database of System-atic Reviews, No. 1, CD001059. [Google Scholar] [CrossRef] 
[6] Chen, Q., Stone, P.R., McCowan, L.M.E. and Chamley, L.W. (2006) Phagocytosis of Necrotic but Not Apoptotic Trophoblasts Induces Endothelial Cell Activation. Hypertension, 47, 116-121. [Google Scholar] [CrossRef] 
[7] Chen, Q., et al. (2013) Pre-Treatment with Calcium Prevents Endothelial Cell Activation Induced by Multiple Activators, Necrotic Trophoblastic Debris or IL-6 or Preeclamptic Sera: Possible Relevance to the Pathogenesis of Preeclampsia. Placenta, 34, 1196-1201. [Google Scholar] [CrossRef] [PubMed]
[8] Cotter, A.M., Molloy, A.M., Scott, J.M. and Daly, S.F. (2001) Elevated Plasma Homocysteine in Early Pregnancy: A Risk Factor for the Development of severe Preeclampsia. Ameri-can Journal of Obstetrics & Gynecology, 185, 781-785. [Google Scholar] [CrossRef] [PubMed]
[9] Schini-Kerth, V.B. (2003) Homocysteine, a Proinflammatory and Proatherosclerotic Factor: Role of Intracellular Reactive Oxygen Species. Circulation Research, 93, 271-273. [Google Scholar] [CrossRef] 
[10] Williams, P.J., Bulmer, J.N., Innes, B.A. and Broughton, P.F. (2011) Possible Roles for Folic Acid in the Regulation of Trophoblast Invasion and Placental Develop-ment in Normal Early Human Pregnancy. Biology of Reproduction, 84, 1148-1153. [Google Scholar] [CrossRef] [PubMed]
[11] Wang, Y., et al. (2014) The Globular Heads of the C1q Re-ceptor Regulate Apoptosis in Human Extravillous Cytotrophoblast-Derived Transformed Cells via a Mitochon-dria-Dependent pathway. American Journal of Reproductive Immunology, 71, 73-85. [Google Scholar] [CrossRef] [PubMed]
[12] Wang, F., Cao, G., Yi, W., Li, L. and Cao, X. (2019) Effect of Metformin on a Preeclampsia-Like Mouse Model Induced by High-Fat Diet. BioMed Research International, 2019, Article ID: 6547019. [Google Scholar] [CrossRef] [PubMed]
[13] Luo, F., et al. (2019) Metformin in Patients with and without Diabetes: A Paradigm Shift in Cardiovascular Disease Management. Cardiovascular Diabetology, 18, Article No. 54. [Google Scholar] [CrossRef] [PubMed]
[14] Bakhashab, S., et al. (2016) Metformin Improves the Angiogenic Potential of Human CD34+ Cells Co-Incident with Downregulating CXCL10 and TIMP1 Gene Expression and Increas-ing VEGFA under Hyperglycemia and Hypoxia within a Therapeutic Window for Myocardial Infarction. Cardiovascular Diabetology, 15, Article No. 27. [Google Scholar] [CrossRef] [PubMed]
[15] Brownfoot, F.C., et al. (2016) Metformin as a Prevention and Treatment for Preeclampsia: Effects on Soluble Fms-LIKE Tyrosine Kinase 1 and Soluble Endoglin Secretion and Endo-thelial Dysfunction. American Journal of Obstetrics & Gynecologyl, 214, e1-e356. [Google Scholar] [CrossRef] [PubMed]
[16] Cotechini, T. and Graham, C.H. (2015) Aberrant Maternal Inflam-mation as a Cause of Pregnancy Complications: A Potential Therapeutic Target? Placenta, 36, 960-966. [Google Scholar] [CrossRef] [PubMed]
[17] Li, S.-N., et al. (2009) Metformin Inhibits Nuclear Factor κB Activation and Decreases Serum High-Sensitivity C-Reactive Protein Level in Experimental Atherogenesis of Rabbits. Heart & Vessels, 24, 446-453. [Google Scholar] [CrossRef] [PubMed]
[18] Kim, J., et al. (2014) Metformin Suppresses Lipopolysaccharide (LPS)-Induced Inflammatory Response in Murine Macrophages via Activating Transcription Factor-3 (ATF-3) Induction. Journal of Biological Chemistry, 289, 23246-23255. [Google Scholar] [CrossRef] 
[19] Hattori, Y., Suzuki, K., Hattori, S. and Kasai, K. (2006) Metformin Inhibits Cytokine-Induced Nuclear Factor κB Activation Via AMP-Activated Protein Kinase Activation in Vascular En-dothelial Cells. Hypertension, 47, 1183-1188. [Google Scholar] [CrossRef] 
[20] Hu, J., Zhang, J. and Zhu, B. (2019) Protective Effect of Metformin on a Rat Model of Lipopolysaccharide-Induced Preeclampsia. Fundamental & Clinical Pharmacology, 33, 649-658. [Google Scholar] [CrossRef] [PubMed]
[21] Alqudah, A., et al. (2018) Risk of Pre-Eclampsia in Women Tak-ing Metformin: A Systematic Review and Meta-Analysis. Diabetic Medicine, 35, 160-172. [Google Scholar] [CrossRef] [PubMed]
[22] Syngelaki, A., et al. (2016) Metformin versus Placebo in Obese Pregnant Women without Diabetes Mellitus. The New England Journal of Medicine, 374, 434-443. [Google Scholar] [CrossRef] 
[23] Costantine, M.M., et al. (2010) Using Pravastatin to Improve the Vascular Reactivity in a Mouse Model of Soluble Fms-Like Tyrosine Kinase-1-Induced Preeclampsia. Obstetrics & Gy-necology, 116, 114-120. [Google Scholar] [CrossRef] 
[24] Esteve-Valverde, E., et al. (2018) Pravastatin for Preventing and Treating Preeclampsia: A Systematic Review. Obstetrics & Gynecology Survy, 73, 40-55. [Google Scholar] [CrossRef] 
[25] Kumasawa, K., et al. (2011) Pravastatin Induces Placental Growth Factor (PGF) and Ameliorates Preeclampsia in a Mouse Model. PNAS, 108, 1451-1455. [Google Scholar] [CrossRef] [PubMed]
[26] Bauer, A.J. et al. (2013) Pravastatin Attenuates Hypertension, Oxi-dative Stress and Angiogenic Imbalance in Rat Model of Placental Ischemia-Induced Hypertension. Hypertension, 61, 1103-1110. [Google Scholar] [CrossRef] 
[27] Ma’Ayeh, M., Rood, K.M., Kniss, D. and Cos-tantine, M.M. (2020) Novel Interventions for the Prevention of preeclampsia. Current Hypertension Reports, 22, Article No. 17. [Google Scholar] [CrossRef] [PubMed]
[28] Ahmed, A., et al. (2020) Pravastatin for Early-Onset Pre-Eclampsia: A Randomised, Blinded, Placebo-Controlled Trial. BJOG, 127, 478-488. [Google Scholar] [CrossRef] [PubMed]
[29] Costantine, M.M., et al. (2016) Safety and Pharmacokinetics of Pravastatin Used for the Prevention of Preeclampsia in High-Risk Pregnant Women: A Pilot Randomized Controlled Tri-al. American Journal of Obstetrics & Gynecology, 214, e1-e720. [Google Scholar] [CrossRef] [PubMed]

为你推荐