早期妊娠先兆子痫的预测生化因素

Lorna Muscat Baron, Byron Baron
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摘要

先兆子痫(PE)是主要妊娠并发症之一,在世界某些地区影响到10%的妊娠。临床诊断以高血压和蛋白尿为特征,通常在妊娠后期,加上无法治疗(分娩除外),可导致母亲和未出生胎儿的显著发病率和死亡率。此外,目前仅接受小剂量阿司匹林作为PE的预防措施。这加大了从血液或尿液中识别PE诊断和预后生物标志物的压力,以便在妊娠变得复杂之前对孕妇进行无创筛查。多年来,许多DNA和蛋白质分子,如细胞游离DNA、VEGF、sFLT1、PlGF、PP-13、ADMA和其他一些生物标志物,已经与特定的病理生理观察相关联,并被认为是PE的预测标志物。然而,它们的可靠性和可重复性已经被大量的研究所检验。本综述的目的是涵盖妊娠合并PE的关键临床和生化特征,并评估从各种研究中收集的数据的稳健性,以便更好地了解所提出的生物标志物与PE发展之间的联系,从而更好地量化它们在诊断或预后应用中的相关性。总体目标是使用这些生物标志物进行早期检测,更好的分子监测,并在可能的情况下减轻症状,希望能够减少全球每年与pe相关的死亡人数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive Biochemical Factors for Pre-Eclampsia in Early Pregnancy
Pre-eclampsia (PE) is one of the major pregnancy complications, affecting up to 10% of all pregnancies in some regions of the world. The clinical diagnosis, characterised by hypertension and proteinuria often late during pregnancy, with the added inability to treat (other than delivery), can lead to significant morbidity and mortality in both mother and unborn foetus. Moreover, as yet only low dose aspirin administration is accepted as a preventive measures for PE. This puts more pressure to identify diagnostic and prognostic biomarkers of PE from blood or urine for the non-invasive screening of pregnant women before a pregnancy becomes complicated. Over the years, a number of DNA and protein molecules, such as cell free DNA, VEGF, sFLT1, PlGF, PP-13, ADMA and several other biomarkers, have been linked to specific pathophysiological observations and proposed as predictive markers for PE. However, their reliability and reproducibility has been put to test by numerous studies. The aim of this review is to cover the key clinical and biochemical features of pregnancies complicated by PE and evaluate the robustness of data gathered from various studies in order to better understand the link between the proposed biomarkers and the development of PE so as to better quantify their relevance in diagnostic or prognostic applications. The overall goal is to use such biomarkers for earlier detection, better molecular monitoring, and where possible lessening of symptoms, hopefully leading to a reduction in the yearly PE-related deaths worldwide.
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