孕前的临床发病之前的前环素和血栓素变化:一个多中心前性研究
J L Mills1, R DerSimonian, E Raymond
1Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
JAMA
|August 4, 1999
概括
降低的前环素 (PGI2) 生产,而不是增加的血栓素A2 (TxA2),先于产前的发病. 这一发现表明,未来的干预措施应专注于纠正PGI2缺乏,以重新平衡孕前的eicosanoid水平.
科学领域:
- 产科和妇科 产科和妇科
- 心血管生理学心血管生理学
- 生殖医学 生殖医学
背景情况:
- 孕前症涉及血管扩展前素 (PGI2) 和血管收缩血栓素A2 (TxA2) 之间的不平衡.
- 以前针对TxA2的阿司匹林试验未能预防孕前,因此需要对eicosanoid变化的时间进行调查.
- 目前尚不清楚,伊可索类物质的变化是否是孕前的原因或后果.
研究的目的:
- 调查PGI2或Txa2的变化是否发生在孕前临床表现之前.
- 为了确定eicosanoid不平衡和产前的发展之间的时间关系.
主要方法:
- 一个多中心前性研究,涉及妇女从安慰剂手臂的为孕前预防试验 (1992-1995) 的.
- 将患有妊娠前的女性 (n=134) 与匹配的正常血压对照 (n=139) 的女性进行比较.
- 在多个妊娠点 (在22周之前,26-29周之前和36周之前) 测量尿前素 (PGI-M) 和血栓素A2 (Tx-M) 代谢物.
主要成果:
- 患有孕前的女性在整个怀孕期间表现出明显较低的PGI-M水平,早在13-16周怀孕时就明显.
- 妊娠年龄调整后的PGI-M水平在孕前妇女中比对照女性低17%.
- 两组之间Tx-M水平没有显著差异,但Tx-M与PGI-M的比率在孕前妇女中高出24%,表明向血管收缩转移.
结论:
- 降低前列腺素 (PGI2) 产量是预先先孕发作的早期事件,在临床诊断前几个月发生.
- 增加的血栓素A2 (TxA2) 生产并不是孕前的主要异常.
- 未来的孕前治疗策略应优先解决前环素缺乏症,以恢复eicosanoid平衡.
相关概念视频
Teratogenicity
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Blood Studies for Cardiovascular System III: Serum Lipid Profile
Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...


