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首页> 外文期刊>Hypertension: An Official Journal of the American Heart Association >Low Soluble Fms-Like Tyrosine Kinase-1, Endoglin, and Endothelin-1 Levels in Women With Confirmed or Suspected Preeclampsia Using Proton Pump InhibitorsNovelty and Significance
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Low Soluble Fms-Like Tyrosine Kinase-1, Endoglin, and Endothelin-1 Levels in Women With Confirmed or Suspected Preeclampsia Using Proton Pump InhibitorsNovelty and Significance

机译：使用质子泵抑制剂对已确诊或怀疑先兆子痫的妇女的低可溶性Fms样酪氨酸激酶1，内皮糖蛋白和内皮素1的水平具有新颖性和意义

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Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement. Measurements were only made once, at study entry between weeks 20 and 41 (median 33 weeks). PPI use was associated with lower sFlt-1 levels, with no change in placental growth factor levels, both when compared with all non-PPI users and with 80 gestational age-matched controls selected from the non-PPI users. No sFlt-1/placental growth factor alterations were observed in women using ferrous fumarate or macrogol while, as expected, women using antihypertensive medication displayed higher sFlt-1 levels and lower placental growth factor levels. The PPI use-associated decrease in sFlt-1 was independent of the application of antihypertensive drugs and also occurred when restricting our analysis to patients with hypertensive disease of pregnancy at study entry. PPI users displayed more cases with preexisting proteinuria, less gestational hypertension, and a lower number of neonatal sepsis cases. Finally, their plasma endoglin and endothelin-1 levels were lower while sFlt-1 levels correlated positively with both. In conclusion, PPI use associates with low sFlt-1, endoglin, and endothelin-1 levels, warranting prospective trials to investigate the therapeutic potential of PPIs in preeclampsia.
机译：子痫前期患者显示胎盘来源的sFlt-1（可溶性Fms样酪氨酸激酶-1）和内皮糖蛋白水平升高，胎盘生长因子水平降低。质子泵抑制剂（PPI）在体外可减少滋养细胞sFlt-1和内皮糖蛋白的分泌。 PPI在怀孕期间用于抵抗反流疾病。在这里，我们通过一项涉及430名女性的前瞻性队列研究，调查了PPI是否会影响已确诊/怀疑先兆子痫的女性的sFlt-1。在这些妇女中，有40位在进行sFlt-1测量前8到45天（中位数29）服用了PPI（6埃索美拉唑，32奥美拉唑和2 pan托拉唑）。在进入研究的第20周到41周之间（中值33周），仅进行了一次测量。与所有非PPI使用者和选自非PPI使用者的80个与胎龄匹配的对照相比，PPI的使用与较低的sFlt-1水平相关，而胎盘生长因子水平无变化。在使用富马酸亚铁或聚乙二醇的女性中未观察到sFlt-1 /胎盘生长因子的变化，而正如预期的那样，使用降压药的女性表现出较高的sFlt-1水平和较低的胎盘生长因子水平。与PPI使用相关的sFlt-1降低与降压药的应用无关，并且在将我们的分析限制为研究开始时患有妊娠高血压疾病的患者时也会发生。 PPI用户显示出更多的既往存在蛋白尿的病例，较少的妊娠高血压和较少的新生儿败血症病例。最后，他们的血浆内皮糖蛋白和内皮素-1水平较低，而sFlt-1水平与两者呈正相关。总之，PPI的使用与sFlt-1，内皮糖蛋白和内皮素-1水平低相关，因此有必要进行前瞻性试验，以研究PPI在先兆子痫中的治疗潜力。

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