Prothrombotic state associated with preeclampsia.
Prothrombotic state associated with preeclampsia.
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与先兆子痫相关的血栓前状态。
DOI：
10.1097/moh.0000000000000678
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发表时间：
2021-09-01
影响因子：
3.2
通讯作者：
Dong JF
中科院分区：
文献类型：
--
作者：
Han C;Chen YY;Dong JF
先兆子痫是一种常见的妊娠并发症，并有助于显着的母亲和胎儿的发病率和死亡率。妊娠晚期出现的保护性高凝状态可演变为先兆子痫患者的血栓前状态。这种血栓前转变的潜在机制仍然知之甚少。我们讨论了了解子痫前期和相关血栓前状态的病理生理学的最新进展。妊娠期间发展的高凝状态是由胎盘因素引发的，当胎盘受到缺血和氧化损伤时，在先兆子痫中发展为血栓前状态。然而，先兆子痫诱导的血栓前状态的原因是多因素的，不仅涉及胎盘因素，还涉及母体条件，包括遗传易感性、预先存在的医学条件和妊娠期间获得的条件。内皮病是先兆子痫的主要病理，通过诱导凝血、血小板和粘附配体的失调而促成血栓前状态。先兆子痫患者通常会出现严重的血栓前状态，使其在妊娠期间和妊娠后易于发生危及生命的血栓形成和血栓栓塞。早期识别和治疗这种血栓前状态可以改善先兆子痫患者的母婴结局。
Preeclampsia is a common complication of pregnancy and contributes significantly to maternal and fetal morbidity and mortality. A protective hypercoagulable state that is developed during late pregnancy can evolve into a prothrombotic state in patients with preeclampsia. The underlying mechanism of this prothrombotic transition remains poorly understood. We discuss recent progress in understanding the pathophysiology of preeclampsia and associated prothrombotic state. The hypercoagulable state developed during pregnancy is initiated by placental factors and progresses into the prothrombotic state in preeclampsia when the placenta is subjected ischemic and oxidative injuries. However, the cause of the preeclampsia-induced prothrombotic state is multifactorial, involving not only placental factors but also maternal conditions, which include genetic predisposition, pre-existing medical conditions, and conditions acquired during pregnancy. Endotheliopathy is the primary pathology of preeclampsia and contributes to the prothrombotic state by inducing the dysregulation of coagulation, platelets, and adhesive ligands. Patients with preeclampsia often develop a severe prothrombotic state that predisposes them to life-threatening thrombosis and thromboembolism during and after pregnancy. Early recognition and treatment of this prothrombotic state can improve maternal and infant outcomes of preeclampsia patients.