二甲双胍在子痫前期中治疗潜能的研究进展

Research advances in the therapeutic potential of metformin for preeclampsia

子痫前期是妊娠期的一种严重并发症,是造成妊娠不良结局的一大主要病因,降压、解痉、镇静是主要的治疗原则,但终止妊娠仍是唯一有效的治疗方法。目前对于其发病机制主要采用“二阶段”学说,而在第二阶段胎盘因子入母体血循环后,引起母体的一系列病理改变(如血管内皮的损伤、炎症反应的过度激活)会对母体的多器官功能带来损伤。二甲双胍作为一种有效的口服降糖药物,有强大的生物学效应,其在治疗其他疾病方面的作用也逐渐得到肯定,如治疗多囊卵巢疾病、大网膜血管、充血性心力衰竭、慢性肝肾疾病等。而二甲双胍在治疗这些疾病时所体现的改善血管内皮功能、增加血流量以及抑制炎症因子的作用,在子痫前期的预防及治疗可能具有临床价值。

Preeclampsia is a serious complication of pregnancy and a major cause of adverse outcome of pregnancy.Antihypertension,spasmolysis and sedation are the main therapeutic principles,but termination of pregnancy is still the only effective treatment.At present,the pathogenesis of preeclampsia mainly adopts the"two-stage"theory.In the second stage,a series of pathological changes in the mother caused by placental factors entering the maternal blood circulation,such as damage to the vascular endothelium and excessive activation of inflammatory response,will cause damage to the mother′s multiple organ functions.As an effective oral hypoglycemic drug,metformin has a powerful biological effect,and its role in the treatment of other diseases is gradually recognized,for example,in the treatment of polycystic ovary disease,greater omental vessels,congestive heart failure,chronic kidney and liver disease.Metformin,which can improve vascular endothelial function,increase blood flow and inhibit inflammatory factors in the treatment of these diseases,may show its great clinical value in the prevention and treatment of preeclampsia.