Brennan Lesley J, Morton Jude S, Davidge Sandra T
Department of Obstetrics and Gynaecology, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute and the Cardiovascular Research Centre, Edmonton, Alberta, Canada.
Microcirculation. 2014 Jan;21(1):4-14. doi: 10.1111/micc.12079.
Preeclampsia is a complex disorder which affects an estimated 5% of all pregnancies worldwide. It is diagnosed by hypertension in the presence of proteinuria after the 20th week of pregnancy and is a prominent cause of maternal morbidity and mortality. As delivery is currently the only known treatment, preeclampsia is also a leading cause of preterm delivery. Preeclampsia is associated with maternal vascular dysfunction, leading to serious cardiovascular risk both during and following pregnancy. Endothelial dysfunction, resulting in increased peripheral resistance, is an integral part of the maternal syndrome. While the cause of preeclampsia remains unknown, placental ischemia resulting from aberrant placentation is a fundamental characteristic of the disorder. Poor placentation is believed to stimulate the release of a number of factors including pro- and antiangiogenic factors and inflammatory activators into the maternal systemic circulation. These factors are critical mediators of vascular function and impact the endothelium in distinctive ways, including enhanced endothelial oxidative stress. The mechanisms of action and the consequences on the maternal vasculature will be discussed in this review.
子痫前期是一种复杂的病症，全球约5%的妊娠会受其影响。在妊娠20周后，出现蛋白尿并伴有高血压时可诊断为子痫前期，它是孕产妇发病和死亡的一个主要原因。由于目前分娩是唯一已知的治疗方法，子痫前期也是早产的主要原因。子痫前期与孕产妇血管功能障碍有关，会导致孕期及产后出现严重的心血管风险。内皮功能障碍导致外周阻力增加，是孕产妇综合征的一个重要组成部分。虽然子痫前期的病因尚不清楚，但胎盘植入异常导致的胎盘缺血是该病症的一个基本特征。胎盘植入不佳被认为会刺激多种因子释放到母体全身循环中，这些因子包括促血管生成因子、抗血管生成因子和炎症激活剂。这些因子是血管功能的关键介质，以独特方式影响内皮，包括增强内皮氧化应激。本综述将讨论其作用机制以及对母体血管系统的影响。
