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作 者:李杰芃 程瑶 刘泽君 叶明珠 孙国强 LI Jie-peng;CHENG Yao;LIU Ze-jun;YE Ming-zhu;SUN Guo-qiang(Joint Training Base of Hubei Maternal and Child Health Hospital,Wuhan University of Science and Technology,Wuhan 430070,China;Department of Obstetrics,Maternal and Child Health Hospital of Hubei Province,Wuhan 430070,China)
机构地区:[1]武汉科技大学湖北省妇幼保健院联合培养基地,430070 [2]湖北省妇幼保健院产科
出 处:《国际妇产科学杂志》2024年第1期5-9,86,共6页Journal of International Obstetrics and Gynecology
基 金:湖北省妇幼保健院科研课题(2021AMCHS003)。
摘 要:子痫前期(preeclampsia,PE)是导致孕产妇围产期病死率升高的主要原因之一,其发病机制尚未完全明确。目前研究发现妊娠期体内多种维生素水平与PE发病有关。维生素D在PE发病过程中参与了胎盘形成、炎症反应、氧化应激和免疫激活等,其缺乏可通过以上多种机制导致PE。维生素E的水平在PE患者体内低于正常孕妇,其缺乏可能会增加PE患病风险,但具体机制尚未明确,可能与其抗氧化作用有关。维生素A的水平与PE的关系存在争议。PE发病还与同型半胱氨酸、叶酸(维生素B9)、维生素B12、维生素B6即一碳代谢密切相关,相关维生素缺乏可导致同型半胱氨酸代谢障碍,从而引起PE。维生素B3主要通过保护血管内皮及调节氧化还原反应而对PE产生保护作用。维生素C缺乏与PE发病相关,同时在PE患者补液治疗时应用维生素C可在一定程度上减少肺水肿的发生。Preeclampsia(PE)is one of the main causes of increased perinatal mortality,and its pathogenesis remains unclear.The present study has found that the levels of multivitamins during pregnancy were correlated with incidence of PE.It has been proved that vitamin D is involved in placental formation,inflammatory reaction,oxidative stress and immune activation in the pathogenesis of PE.Vitamin D deficiency can lead to PE through the above mechanisms.In addition,the levels of vitamin E in patients with PE are lower than those in normal pregnant women,suggesting that the lack of vitamin E may increase the risk of PE,but the specific mechanism is still under investigation,it may be related to its antioxidant activity.The relationship between vitamin A levels and PE is controversial.PE is also associated with homocysteine,folic acid(vitamin B9),vitamin B12 and vitamin B6,also known as carbon metabolism.The deficiency of related vitamins leads to homocysteine metabolism disorder,thus causing PE.Vitamin B3 primarily protects against PE by preserving the endothelium and regulating redox reactions.Vitamin C deficiency is associated with PE,and the use of vitamin C during fluid replacement therapy can partially reduce the incidence of pulmonary edema.
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