持续气道正压通气联合可溶性血管内皮生长因子受体-1治疗慢性高血压孕妇睡眠呼吸障碍：病例报告及文献综述
Sleep disordered breathing controlled by CPAP and sFlt-1 in a pregnant patient with chronic hypertension: Case report and literature review.
作者信息
Daly Amy, Robertson Annette, Bobek Gabriele, Middleton Sally, Sullivan Colin, Hennessy Annemarie
机构信息
1School of Medicine, Western Sydney University, Penrith, NSW, Australia.
2Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
出版信息
Obstet Med. 2018 Mar;11(1):32-34. doi: 10.1177/1753495X17708949. Epub 2017 Sep 13.
BACKGROUND
There is recent interest exploring the possible impact of sleep disordered breathing on the mechanisms of preeclampsia. A biomarker of preeclampsia, soluble fms-like tyrosine kinase-1, has come to prominence in recent years. The aim of this study was to investigate the relationship between continuous positive airway pressure treatment, sleep disordered breathing and soluble fms-like tyrosine kinase-1 concentrations during pregnancy.
METHODS
A 38-year-old G1P0 presented at 20 + 5 weeks. She had a history of chronic hypertension. Sleep studies revealed she had sleep disordered breathing with an AHI of 7.3/h. She was commenced on continuous positive airway pressure. Soluble fms-like tyrosine kinase-1 concentrations and blood pressure recordings were taken at various points during her pregnancy.
RESULTS
She did not develop preeclampsia or require an escalation in her antihypertensives. Soluble fms-like tyrosine kinase-1 concentrations rose 16% from a low baseline. She remained compliant with her continuous positive airway pressure. She progressed to birth a well, live, term baby.
CONCLUSION
Continuous positive airway pressure treatment controlled sleep disordered breathing in a high risk pregnant woman with chronic hypertension with no increase in soluble fms-like tyrosine kinase-1 concentrations.
背景
近年来，人们对探索睡眠呼吸障碍对先兆子痫发病机制的潜在影响产生了兴趣。先兆子痫的一种生物标志物——可溶性fms样酪氨酸激酶-1，近年来备受关注。本研究旨在探讨孕期持续气道正压通气治疗、睡眠呼吸障碍与可溶性fms样酪氨酸激酶-1浓度之间的关系。
方法
一名38岁的初产妇在孕20⁺⁵周就诊。她有慢性高血压病史。睡眠研究显示她存在睡眠呼吸障碍，呼吸暂停低通气指数为7.3次/小时。她开始接受持续气道正压通气治疗。在她孕期的不同时间点测量了可溶性fms样酪氨酸激酶-1浓度和血压。
结果
她未发生先兆子痫，也无需增加降压药物剂量。可溶性fms样酪氨酸激酶-1浓度从较低的基线水平上升了16%。她持续依从持续气道正压通气治疗。她顺利产下一名健康的足月活婴。
结论
持续气道正压通气治疗控制了一名患有慢性高血压的高危孕妇的睡眠呼吸障碍，且可溶性fms样酪氨酸激酶-1浓度未升高。
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