STUDY ON THE PATHOPHYSIOLOGY OF PREECLAMPSIA : THE MECHANISM OF VASOSPASMS

先兆子痫的病理生理学研究：血管痉挛的机制

• 批准号: 08457439
• 负责人: KOBAYASHI Takao
• 金额: $ 4.8万
• 依托单位: HAMAMATSU UNIVERSITY SCHOOL OF MEDECINE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08457439/
• 关键词: PREECLAMPSIA; VASOSPASMS; HYPERCOAGULABILITY; MR ANGIOGRAPHY; ANGIOSPASTIC SYNDROME; SYMPATHETIC NERVE; EPIDURAL ANESTHESIA; Angiospastic syndrome; 腹部交感神経節; 左腎静脈; カテコラミン; トロンビン; ATIII(アンチトロビンIII); 重症妊娠中毒症; 子癇; HELLP症候群; 血管攣縮; Shear stress

Preeclampsia has pathophysiological disorders specific to pregnancy characterized by vasoconstriction and hypercoagulability. We investigated MR angiography in many cases of preeclampsia and revealed vasospasms of cerebral arteries. We proposed that preeclampsia was the angiospastic syndrome of pregnancy from the view point of vasospasms.An analysis of the results of coagulation/fibrinolysis investigation lead to the hypothesis that 1) even in patients with severe preeclampsia, vaginal deliveries can be successful in cases with a lower hypercoagulable state, 2) an excessive hypercoagulable state in patients with severe preeclampsia is associated with the termination of pregnancy, especially resulting from the aggravation of maternal factors, and 3) among these markers, a depletion in platelet counts (DELTA pit) and an increase in the D-dimer and AT-Ill during pregnancy are thought to be useful bedside predictive markers for the termination of pregnancy complicated by severe preeclampsia.Chronic local cold stimulation of the soles of the paws induces preeclampsia-like phenomena in pregnant and nonpregnant rats, and we revealed the effectiveness of long-term epidural anesthesia by bupivacaine in patients with severe preeclampsia. These facts suggest that the cause of preeclampsia is involved in chronic stimulation of the sympathetic nerve.

先兆子痫具有妊娠特有的病理生理障碍，其特征是血管收缩和高凝状态。我们研究了许多先兆子痫患者的磁共振血管成像，发现脑血管痉挛。我们从血管痉挛的角度提出子痫前期是妊娠的血管痉挛综合征。通过对凝血/纤溶研究结果的分析，得出以下假设：1)即使在重度子痫前期患者中，高凝状态较低的患者也可以成功地阴道分娩；2)重度子痫前期患者的过度高凝状态与终止妊娠有关，特别是由于母体因素的加重，以及3)在这些标记物中，妊娠期间血小板计数减少(Delta PIT)、D-二聚体和AT-Ill升高被认为是终止妊娠合并重度子痫前期的有用床边预测指标。慢性局部爪底冷刺激导致妊娠和未怀孕大鼠出现类似先兆子痫的现象，我们揭示了布比卡因长期硬膜外麻醉对重度子痫前期患者的有效性。这些事实表明，子痫前期的原因与交感神经的慢性刺激有关。

项目成果

Tokunaga N,Kobayashi T: "Imaging analysis of the maternal great vessels in early-onset preeclampsia." 29th International congress on the Pathophysiology of Pregnancy. (1997)

Tokunaga N，Kobayashi T：“早发性先兆子痫母体大血管的影像分析。”

Halim A: "Immunohistological study in cases of HELLP syndrome (hemolysis,elevated liver enzyme and low platelets) and acute fatty liver of pregnancy." Gynecol Obstet Invest. 41. 106-112 (1996)

Halim A：“HELLP 综合征（溶血、肝酶升高和血小板低）和妊娠期急性脂肪肝病例的免疫组织学研究。”

Sugimura M: "Immunohistological study on tissue factor (TF) and annexin Vin placentas complicated with preeclampsia." Placenta. 17. A.8- (1996)

Sugimura M：“组织因子（TF）和膜联蛋白 Vin 胎盘并发先兆子痫的免疫组织学研究。”

Kobayashi T,Sugimura M,Kanayama N,Nishiguchi T,Tokunaga N,Terao T: "Coagulation/fibrinolysis disorders in patient with severe preeclampsia." Semin Thromb Hemost. (in press). (1999)

Kobayashi T、Sugimura M、Kanayama N、Nishiguchi T、Tokunaga N、Terao T：“严重先兆子痫患者的凝血/纤溶障碍。”

Khatun S,Kobayashi T: "Eclamptic plasma stimulates norepinephrine release in cultured sympathetic nerve" Hypertension. 31(6). 1343-1349 (1998)

Khatun S，Kobayashi T：“子痫血浆刺激培养交感神经中去甲肾上腺素的释放”高血压。