Department of Obstetrics and Gynecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
Department of Obstetrics and Gynecology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
Microvasc Res. 2018 Mar;116:71-76. doi: 10.1016/j.mvr.2017.11.001. Epub 2017 Nov 8.
Preeclampsia (PE) is a pregnancy related endothelial disease characterized by hypertension and albuminuria. Postpartum endothelial dysfunction often persists in these women. We postulate that in women with a history of PE reduced endothelial dependent vasodilation coincides with attenuated kidney function, as both reflect endothelial dysfunction.
We assessed endothelial and kidney function in women with a history of PE (n=79) and uncomplicated pregnancies (n=49) at least 4years postpartum. Women with hypertension, diabetes or kidney disease prior to pregnancy were excluded. Brachial artery flow mediated dilatation (FMD) was measured and analysed by a custom designed edge-detection and wall-tracking software. We measured albumin and creatinine levels in a 24-h urine sample and calculated glomerular filtration rate (GFR) by CKD-EPI.
Women with a history of PE had lower FMD but comparable GFR and albumin creatinine ratio (ACR) compared with controls. Independent of obstetric history, in both controls and women with a history of PE respectively, GFR (r=0.19, p=0.17 and r=0.12, p=0.29) and albumin creatinine ratio (r=0.07, p=0.62 and r=0.06 p=0.57) did not correlate with FMD.
At least 4years after pregnancy, women with a history of PE demonstrated decreased flow mediated dilatation when compared to healthy parous controls. In this study, decreased flow mediated dilation however did not coincide with decreased kidney function.
子痫前期(PE)是一种与妊娠相关的内皮疾病,其特征是高血压和蛋白尿。这些女性产后往往存在内皮功能障碍。我们假设,患有 PE 病史的女性,其内皮依赖性血管舒张功能降低与肾功能减弱相吻合,因为这两者均反映了内皮功能障碍。
我们评估了至少 4 年产后有 PE 病史(n=79)和无并发症妊娠史(n=49)的女性的内皮和肾功能。排除了妊娠前患有高血压、糖尿病或肾脏疾病的女性。肱动脉血流介导的扩张(FMD)通过定制的边缘检测和壁跟踪软件进行测量和分析。我们测量了 24 小时尿液样本中的白蛋白和肌酐水平,并通过 CKD-EPI 计算肾小球滤过率(GFR)。
与对照组相比,患有 PE 病史的女性 FMD 降低,但 GFR 和白蛋白肌酐比(ACR)相当。独立于产科史,在对照组和患有 PE 病史的女性中,GFR(r=0.19,p=0.17 和 r=0.12,p=0.29)和白蛋白肌酐比(r=0.07,p=0.62 和 r=0.06,p=0.57)均与 FMD 无关。
至少在产后 4 年后,与健康生育对照组相比,患有 PE 病史的女性表现出流量介导的舒张功能降低。然而,在这项研究中,流量介导的舒张功能降低与肾功能减弱并不一致。