构建三阶段妊娠期高血压患者心血管风险防治框架  

Establishing a three-stage prevention and treatment framework for cardiovascular risk prevention and management in patients with hypertension disorders in pregnancy

作　　者：方艺文 李京格 时慧华 韩姹[2] 杨清 周欣 FANG Yiwen;LI Jingge;SHI Huihua;HAN Cha;YANG Qing;ZHOU Xin(Department of Cardiology,Tianjin Medical University General Hospital,Tianjin 300052,China;不详)

机构地区：[1]天津医科大学总医院心血管内科,天津300052 [2]天津医科大学总医院产科

出　　处：《中国预防医学杂志》2024年第9期1085-1091,共7页Chinese Preventive Medicine

基　　金：国家自然科学基金资助项目(72274133);国家自然科学基金创新研究群体项目(82321001)。

摘　　要：妊娠期高血压疾病(hypertension disorders in pregnancy,HDP)是一组与孕期血压升高相关的临床综合征。HDP不仅是全球范围内孕产妇和围产儿死亡的主要原因之一,而且对孕产妇及其子代的短期和长期心血管与代谢健康构成威胁。早期采取有效的综合防治管理措施至关重要,包括对女性备孕期和妊娠期的预防与干预措施,以及产后心血管代谢危险因素的监测、评估和干预,同时还应涵盖对暴露于HDP的子代的危险因素监测与评估。本研究综述了国内外该领域的研究进展,提出了基于“心血管风险孕期暴露”的三阶段HDP防治框架,即备孕、妊娠及产后三阶段。基层社区医师、产科医师以及心血管内科医师应在不同阶段协同参与HDP的预防、治疗以及远期心血管疾病风险的评估和干预,从“零级预防”的角度开展对心血管疾病的系统防治与管理。Hypertension disorders in pregnancy(HDP)encompass a range of clinical syndromes characterized by elevated blood pressure during pregnancy,which remains a major cause of maternal and perinatal morbidity and mortality worldwide.Furthermore,HDP poses a threat to short-term and long-term maternal cardio-metabolic health concerns.Therefore,the implementation of early and effective comprehensive prevention and management measures is essential,including prevention and intervention of cardio-metabolic risk factors during preconception,pregnancy,and postpartum periods,as well as monitoring,assessment,and intervention of postpartum cardiovascular and metabolic risk factors.Additionally,the framework should address the monitoring and assessment of risk factors in offspring exposed to HDP.This review synthesizes research advancements and proposes a three-stage HDP prevention and treatment framework based on"cardiovascular risk exposure during pregnancy"including preconception,pregnancy,and postpartum stages.Community-based physicians,obstetricians,and cardiologists should collaboratively participate in the management of long-term cardiovascular disease risk of HDP at diferent stages,implementing systematic prevention and management of cardiovascular diseases from primordial prevention.

关 键 词：妊娠期高血压疾病 心血管风险 零级预防 

分 类 号：R54[医药卫生—心血管疾病]