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既往子痫前期及其与未来心血管疾病发展的关系:系统评价和荟萃分析。

Previous preeclampsia and its association with the future development of cardiovascular diseases: a systematic review and meta-analysis.

机构信息

Departamento de Obstetricia e Ginecologia, Hospital Universitario, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR.

Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo (FMRP-USP), SP, BR.

出版信息

Clinics (Sao Paulo). 2021 Jan 20;76:e1999. doi: 10.6061/clinics/2021/e1999. eCollection 2021.

Abstract

Preeclampsia is a multifactorial disease. Among these factors, untreated hypertension during pregnancy can result in high morbidity and mortality rates and may also be related to the future development of cardiovascular diseases.Therefore, this systematic review aimed to determine the association of previous preeclampsia with the future development of cardiovascular diseases. Studies on the association between preeclampsia and future cardiovascular diseases published in the last 10 years (2009-2019) were identified from the PubMed/Medline (207 articles), Embase (nine articles), and Cochrane (three articles) databases using the keywords "preeclampsia" and "future cardiovascular diseases", "preeclampsia" and "future heart attack", and "preeclampsia" and "future cardiac disease". After applying the inclusion and exclusion criteria, 15 articles were analyzed by systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The meta-analysis and the determination of the quality of the articles were conducted using RevMan software, version 5.3. Statistically significant differences were observed between the control and previous preeclampsia groups with respect to systolic blood pressure (mean difference [MD] 4.32; 95% confidence interval [95%CI] 3.65, 4.99; p<0.001), diastolic blood pressure (MD): 2.11; 95%CI: 1.68, 2.55; p<0.0001), and insulin level (MD: 2.80; 95% CI: 0.50, 5.11; p<0.001). Body mass index (MD: 2.57, 95%CI: 2.06, 3.07; p=0.0001), total cholesterol (MD: 10.39; 95%CI: 8.91, 11.87; p=0.0001), HDL (MD: 2.83; 95%CI: 2.20, 3.46; p=0.0001), and LDL (MD: 1.77; 95%CI: 0.42, 3.13; p=0.0001) also differed significantly between groups. Thus, the results of the present study showed that women with a history of preeclampsia were more likely to develop cardiovascular disease.

摘要

子痫前期是一种多因素疾病。其中,妊娠期间未经治疗的高血压可导致高发病率和死亡率,并且可能与未来心血管疾病的发展有关。因此,本系统评价旨在确定既往子痫前期与未来心血管疾病发展之间的关联。从 PubMed/Medline(207 篇文章)、Embase(9 篇文章)和 Cochrane(3 篇文章)数据库中使用关键词“子痫前期”和“未来心血管疾病”、“子痫前期”和“未来心脏病发作”以及“子痫前期”和“未来心脏疾病”,检索了过去 10 年(2009-2019 年)发表的与子痫前期和未来心血管疾病相关的研究。根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,应用纳入和排除标准后,对 15 篇文章进行了系统评价和荟萃分析。使用 RevMan 软件,版本 5.3 进行荟萃分析和文章质量的确定。在控制组和既往子痫前期组之间观察到收缩压(平均差异 [MD]:4.32;95%置信区间 [95%CI]:3.65,4.99;p<0.001)、舒张压(MD):2.11;95%CI:1.68,2.55;p<0.0001)和胰岛素水平(MD:2.80;95%CI:0.50,5.11;p<0.001)有统计学显著差异。体重指数(MD:2.57,95%CI:2.06,3.07;p=0.0001)、总胆固醇(MD:10.39;95%CI:8.91,11.87;p=0.0001)、高密度脂蛋白(MD:2.83;95%CI:2.20,3.46;p=0.0001)和低密度脂蛋白(MD:1.77;95%CI:0.42,3.13;p=0.0001)在组间也有显著差异。因此,本研究结果表明,有子痫前期病史的女性更容易发生心血管疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3801/7798130/205c44c2de93/cln-76-e1999-g001.jpg

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