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早发型子痫前期、晚发型子痫前期及胎儿生长受限中血管生成因子产生紊乱与炎症加剧的共同特征

A Common Profile of Disordered Angiogenic Factor Production and the Exacerbation of Inflammation in Early Preeclampsia, Late Preeclampsia, and Intrauterine Growth Restriction.

作者信息

Kwiatkowski Sebastian, Dołęgowska Barbara, Kwiatkowska Ewa, Rzepka Rafał, Torbè Andrzej, Bednarek-Jędrzejek Magdalena

机构信息

Department of Gynecology and Obstetrics, Pomeranian Medical University, Szczecin, Poland.

Department of Microbiology and Immunology, Pomeranian Medical University, Szczecin, Poland.

出版信息

PLoS One. 2016 Oct 19;11(10):e0165060. doi: 10.1371/journal.pone.0165060. eCollection 2016.

Abstract

Preeclampsia and intrauterine growth restriction are two separate disease entities that, according to numerous reports, share the same pathogenesis. In both, angiogenesis disorders and generalized inflammation are the dominant symptoms. In this study, we hypothesized that both diseases demonstrate the same profile in early preeclampsia, late preeclampsia, and intrauterine growth restriction patients, with the only difference being the degree of exacerbation of lesions. One hundred sixty-seven patients were enrolled in the study and divided into four groups: early preeclampsia, late preeclampsia, and intrauterine growth restriction groups, and one control group. Concentrations of the angiogenesis and inflammatory markers soluble fms-like tyrosine kinase receptor 1, placental growth factor, high-sensitivity C-reactive protein, and interleukin-6 were determined, and the behavior of these markers and correlations among them were studied. Higher concentrations of soluble fms-like tyrosine kinase receptor 1, high-sensitivity C-reactive protein, and interleukin-6 and a lower concentration of placental growth factor were observed in the study groups compared with the control group. No differences in concentrations of the studied markers were found among the study groups but significant correlations were observed. The higher values for the angiogenesis and inflammatory markers both in preeclampsia patients and patients with intrauterine growth restriction of placental origin compared with the control group suggest the existence of the same underlying disorders in the development of these pathologies. The observed mutual correlations for disordered angiogenesis and inflammatory markers are suggestive of a mutual relationship between these processes in the development of pathologies evolving secondary to placental ischemia. The same lesion profile was observed for both preeclampsia and 'placental' intrauterine growth restriction patients, which could be used in developing common diagnostic criteria for pregnant patients.

摘要

子痫前期和胎儿生长受限是两种不同的疾病实体,但根据大量报告,它们具有相同的发病机制。在这两种疾病中,血管生成紊乱和全身性炎症是主要症状。在本研究中,我们假设子痫前期、晚期子痫前期和胎儿生长受限患者在疾病早期具有相同的特征,唯一的区别在于病变的严重程度。167名患者参与了本研究,分为四组:早期子痫前期组、晚期子痫前期组、胎儿生长受限组和一个对照组。测定血管生成和炎症标志物可溶性fms样酪氨酸激酶受体1、胎盘生长因子、高敏C反应蛋白和白细胞介素-6的浓度,并研究这些标志物的变化及其相互关系。与对照组相比,研究组中可溶性fms样酪氨酸激酶受体1、高敏C反应蛋白和白细胞介素-6的浓度较高,而胎盘生长因子的浓度较低。研究组之间所研究标志物的浓度没有差异,但观察到显著的相关性。与对照组相比,子痫前期患者和胎盘源性胎儿生长受限患者的血管生成和炎症标志物值较高,这表明这些病理过程的发展存在相同的潜在紊乱。血管生成紊乱和炎症标志物之间观察到的相互相关性提示了这些过程在胎盘缺血继发的病理发展中的相互关系。子痫前期患者和“胎盘性”胎儿生长受限患者观察到相同的病变特征,这可用于制定针对孕妇的共同诊断标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e1c8/5070778/24113af35bc1/pone.0165060.g001.jpg

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