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Hypertensive Disorders in Pregnancy
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자료설명
Hypertensive Disorders in Pregnancy에 대한 글입니다.
pih-choyg
pih-choyg
본문/내용
원인 및 병인
아직까지 자간전증의 원인은 확실히 밝혀져 있지 않지만, 병인에 있어서는 나선동맥(spiral arteries)의 얕은 혈관내 세포 영양배엽 침입(shallow endovascular cytotrophoblast invasion)과 혈관 내피세포 기능이상(endothelial cell dysfunction)이 가장 중요한 2가지 요소로 알려져 있다. 현재 자간전증의 원인으로서는 4가지 가설이 제시되고 있는데 첫째 태반허혈(placental ischemia), 둘째 VLDL(very low-density lipoproteins)과 VLDL의 독성을 예방할 수 있는 활동력과의 관련성(VLDL versus toxicity preventing activity), 셋째 면역학적 적응의 이상(immune maladaptation), 그리고 넷째로 유전학적 소인(genetic imprinting)이다. 이들 네 가지 요소들은 각각 독립적으로 작용하는 것이 아니고 서로간에 상호작용을 하는 것으로 추측하고 있다.
이들 네 가지 요소들에 대한 설명을 하기 이전에, 정상 임신에서의 자궁-태반 혈액 순환(uteroplacental circulation)과 vascular tone regulation, 자간전증의 병인을 이해하는 것이 도움이 될 것이다.
1. uteroplacental circulation
참고문헌
1. 한영자. 우리나라 모성사망 및 영아사망의 추이. 한국 보건사회 연구원 연구보고서 1998.
2. Working Group on High Blood Pressure in Pregnancy. 1990. National High Blood Pressure Education Program Working Group report on high blood pressure in pregnancy. Am J Obstet Gynecol. 1990;163:1689-1712.
3. Higgins JR. Brennecke SP. Pre-eclampsia - still a disease of theories? Curr Opin Obstet Gynecol 1998;10:129-133.
4. Zuspan FP. New concepts in the understanding of hypertensive disease during pregnancy. Clin Perinatol 1991;18:653.
5. Sibai BM. Preeclampsia-Eclampsia. Current problems in Obstetrics, Gynecology and Fertility 1990;13:21-23.
6. 변지수. 한국에 있어서의 임신성 고혈압증. 대한산부회지 1993;36:737-754.
7. American College of Obstetricians and Gynecologists. Tech Bull No. 219. Hypertens Pregnancy. Washington, DC, 1996.
8. Witlin AG, Sibai BM. Hypertension. Clin Obstet Gynecol 1998;41:533-544.
9. Sibai BM. Diagnosis and management of chronic hypertension in pregnancy. Obstet Gynecol 1991;78:451-461.
10. Redman CWG. Hypertension in Pregancy. In: de Swiet ed. Medical Disorders in Obstetric Practice. London: Blackwell Science, 1995;182-225.
11. Robillard P-Y, Hulsey TC, Janky E, Miri EH, Papiernik E. Association of pregnancy-induced hypertension with duration of sexual cohabitation before pregnancy. Lancet 1994;344:973-975.
12. Knuist M, Bonsel GJ, Zondervan HA, Treffers PE. Risk factors for preeclampsia in nulliparous women in distinct ethnic groups: a prospective cohort study. Obstet Gynecol 1998;92:174-8.
13. Sibai BM, Lindheimer M, Hauth J, Caritis S, VanDorsten P, Klebanoff M et al. Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension. N Engl J Med 1998; 339:667-671.
14. Dekker GA, Sibai BM. Early detection of preeclampsia. Am J Obstet Gynecol 1991;165:160-172.
15. Caritis S, Sibai BM, Hauth J, Lindheimer M, VanDorsten P, Klebanoff M, et al. Predictors of pre-eclampsia in women at high risk. Am J Obstet Gynecol 1998;179:946-51.
16. Pijnenborg R. The placental bed. Hypertens Pregnancy 1996;15:7-23.
17. Zhou Y, Damsk CH, Fisher SJ. Preeclampsia is associated with failure of human cytotrophoblasts to mimic a vascular adhesion phenotype. J Clin Invest 1997; 99:2152-64.
18. Meekins JW. Pijnenborg R, Hanssens M, McFadyen IR, van Assche A. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynecol 1994;101:669-74.
19. Meekins JW, Pijnenborg R, Hanssens M, van Assche A, McFadyen IR. Immunohistochemical detection of lipoprotein in the wall of placental bed spiral arteries in normal and severe pre-eclamptic pregnancies. Placenta 1994;15:511-24.
20. Charnock Jones DS, Sharkey AM, Boocock CA, Ahmed A, Plevin R, Ferrara N, et al. Vascular endothelial growth factor receptor localization and activation in human trophoblast and choriocarcinoma cells. Biol Reprod 1994;41: 524-30.
21. Wheeler T, Elcock CL, Anthony FW. Angiogenesis and the placental environment. Placenta 1995;16:289-96.
22. Hofman GE, Glatsein I, Schatz F, Heller D, Deligdisch L. Immunohistochemical localization of urokinase-type palsminogen activator and the plasminogen activator inhibitors 1 and 2 in early human implantation sites. Am J Obstet Gynecol 1994;170:671-6.
23. Moll UM, Lane BL. Proteolytic activity of first trimester human placenta : localization of interstitial collagenase in villous and extravillous trophoblast. Histochemistry 1990;94:555-60.
24. Zhou Y, Damsky CH, Chiu K, Roberts JM, Fisher SJ. Preeclampsia is associated with abnormal expression of adhesion molecules by invasive cytotrophoblasts. J Clin Invest 1993;91:950-60.
25. Molnar M, Suto T, Toth T, Hertelendy F. Prolonged blockade of nitric oxide synthesis in gravid rats produces sustained hypertension, proteinuria, thrombocytopenia and intrauterine growth retardation. Am J Obstet Gynecol 1994;170:1458-66.
26. Pascoal IF, Umans JG. Effect of pregnancy on mechanisms of relaxation in human omental microvessels. Hypertension 1996;28:183-7.
27. Shanklin DR, Sibai BM. Ultrastructural aspects of preeclampsia. I. Placental bed and uterine boundary blood vessels. Am J Obstet Gynecol 1989;161:735-41.
28. Taylor RN, de Groot CJM, Cho YK, Lim KH. Circulating factors as markers and mediators of endothelial cell dysfunction in preeclampsia. Seminars in Reproductive Endocrinology. 1998;16:17-31.
29. Roberts JM. Endothelial dysfunction in preeclampsia. Seminars in Reproductive Endocrinololgy. 1998;16:5-15.
30. Fiers W. Tumor necrosis factor. Characterization at the molecular, cellular and in vivo level. FEBS 1991;285:199-212.
31. Stark JM. Pre-eclampsia and cytokine induced oxidative stress. Br J Obstet Gynecol 1993;100:105-109.
32. Toborek M, Barger SW, Mattson MP, Barve S, McClain CJ, Hennig B. Linoleic acid and TNF-α cross-amplify oxidative injury and dysfunction of endothelial cells. J Lipid Res 1996;37:123-135.
33. Beutler B, Cerami A. The biology of cachectin/TNF-α primary mediator of the host response. Annu Rev Immunol 1989;7:625-55.
34. Arai K, Lee F, Miyajima A, Miyatake S, Arai N, Yokota T. Cytokine: Coordinators of immune and inflammatory response. Annu Rev Biochem 1990;59:783-836.
35. Roberts JM, Redman CWG, Preclampsia : More than pregnancy-induced hypertension. Lancet 1993;341:1447-1451.
36. Tsukimori K, Ishida K, Maeda H, Koyanaki J, Nakano H, The placeta as possible source of the factor causing endothelial cell injury in preeclampsia. Hypertens Pregnancy 1994;13:358.
37. Potter JM, Nestel PJ. The hyperlipidemia of pregnancy in normal and complicated pregnancies. Am J Obstet Gynecol 1979;133:165-170.
38. Lorentzen B, Endresen MJ, Hovig T, Haug E, Henriksen. Sera from preeclamptic women increase the content of triglycerides and reduce the release of prostacyclin in cultured endothelial cells. Thromb Res 1991;63:363-372.
39. Arbogast BW, Lee GM, Raymond TL. In vitro injury of porcine aortic endothelilal cells by very low density lipoproteins from diabetic rat serum. Diabetes 1982;31:593-599.
40. Arbogast BW, Berry DL, Newell BC. Injury of arterial endothelial cells in diabetic, sucrose-fed and aged rats. Atherosclerosis 1984;51:31-45.
41. Goode GK, Miller JP, Heagerty AM. Hyperlipidemia, hypertension, and coronary heart disease. Lancet 1995;345:362-364.
42. Arbogast BW, Leeper SC, Merrick RD, Olive KE, Taylor RN. Which plasma factors bring about disturbance of endothelial function in preeclampsia? Lancet 1994;343:340-341.
43. Arbogast BW, Leeper SC, Merrick RD, Olive KE, Taylor RN. Plasma factors that determine endothelial cell lipid toxicity in vitro correctly identify women with preeclampsia in early and late pregnancy. Hypertens Pregnancy 1996;15:263-279.
44. Sattar N, Bendomir A, Berry C, Shepherd J, Greer IA, Packard CJ. Lipoprotein subfraction concentrations in preeclampsia: pathogenic parallels to atherosclerosis. Obstet Gynecol 1997;89:403-408.
45. Vigne J-L, Murai JT, Arbogast BW, Jia W, Fisher SJ, Taylor RN. Elevated nonesterified fatty acid concentrations in severe preeclampsia shift the isoelectric characteristics of plasma albumin. J Clin Endocrinol Metab 1997;82:3786-3792.
46. Campbell DM, MacGillivray I, Carr Hill R. Preeclampsia in secondary pregnancy. Br J Obstet Gynecol 1985;92:131-140.
47. van Beek E, Peeters LLH. Pathogenesis of preeclampsia: A comprehensive model. Obstet Gynecol Surv 1998;53:233-239.
48. Carosella ED, Dausset J, Kirszenbaum M. HLA-G revisited. Immunol Today 1996;17:407-9.
49. Colbern GT, Chiang MH, Main EK. Expression of the nonclassic histoco- mpatibility antigen HLA-G by preelamptic placenta. Am J Obstet Gynecol 1994;170:1244-50.
50. Loke YW, King A. Immunology of human placental implantation: clinical implications of our current understanding. Mol Med Today 1997;Apr:153-9.
51. Chesley LC, Annitto JE, Cosgrove RA. The familial factor in toxemia of pregnancy. Obstet Gynecol 1968;32:303-11.
52. Arngrimsson R, Connor JM, Geirsson RT, Brennecke S, Cooper DW. Is genetic susceptibility for preeclampsia and eclampsia associated with implantation failure and fetal demise? Lancet 1994;343:1643-4.
53. Kilpatrick DC, Gibson F, Livingston J, Liston WA. Preeclampsia is associated with HLA-DR4 sharing between mother and fetus. Tissue Antigens 1990;35:178-8.
54. Ward K, Hata A, Jeunemaitre X. A molecular variant of angiotensinogen associated with preeclampsia. Nature Genet 1993;4:59-61.
55. 조용균. 한국인 자간전증 임신부의 angiothesinogen exon 2 M235 유전자의 변이. 1995. 의학박사학위논문.
56. Widschwendter M, Schrocksnadel H, Mortl MG. Preeclampsia: a disorder of placental mitochondria? Mol Med Today 1998;July:286-291
57. Redman CWG, Sacks GP, Sargent IL. Preeclampsia: An excessive maternal inflammatory response to pregnancy. Am J Obstet Gynecol 1999;180:499-506.
58. Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD. et al. Trial of calcium to prevent preeclampsia. N Engl J Med 1997;337:69-76.
59. Collaborative Group: CLASP: A randomized trial of low-dose aspirin for the prevention and treatment of preeclampsia among 9364 pregnant women. Lancet 1994; 343:619-629.
60. Repke JT, Robinson JN. The prevention and management of preeclampsia and eclampsia. Int J Gynecol Obstet 1998;62:1-9.
61. Schiff E, Friedman SA, Sibai BM. Conservative management of severe preeclampsia remote from term. Obstet Gynecol 1994; 84: 626-630.
62. Linton DM, Anthony J. Critical care management of severe preeclampsia. Intensive Care Med 1997;23:248-255.
63. Hsueh WA. Preeclampsia and hypertension in pregnancy. Current Therapy in Endocrinology and Metabolism. 1997;6:324-327.
64. Witilin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol 1998;92:883-9.
65. Repke JT. Preeclampsia and hypertension. In: Repke JT, editor. Intrapartum Obstetrics. New York: Churchill Livingstone, 1996:253-273.
2. Working Group on High Blood Pressure in Pregnancy. 1990. National High Blood Pressure Education Program Working Group report on high blood pressure in pregnancy. Am J Obstet Gynecol. 1990;163:1689-1712.
3. Higgins JR. Brennecke SP. Pre-eclampsia - still a disease of theories? Curr Opin Obstet Gynecol 1998;10:129-133.
4. Zuspan FP. New concepts in the understanding of hypertensive disease during pregnancy. Clin Perinatol 1991;18:653.
5. Sibai BM. Preeclampsia-Eclampsia. Current problems in Obstetrics, Gynecology and Fertility 1990;13:21-23.
6. 변지수. 한국에 있어서의 임신성 고혈압증. 대한산부회지 1993;36:737-754.
7. American College of Obstetricians and Gynecologists. Tech Bull No. 219. Hypertens Pregnancy. Washington, DC, 1996.
8. Witlin AG, Sibai BM. Hypertension. Clin Obstet Gynecol 1998;41:533-544.
9. Sibai BM. Diagnosis and management of chronic hypertension in pregnancy. Obstet Gynecol 1991;78:451-461.
10. Redman CWG. Hypertension in Pregancy. In: de Swiet ed. Medical Disorders in Obstetric Practice. London: Blackwell Science, 1995;182-225.
11. Robillard P-Y, Hulsey TC, Janky E, Miri EH, Papiernik E. Association of pregnancy-induced hypertension with duration of sexual cohabitation before pregnancy. Lancet 1994;344:973-975.
12. Knuist M, Bonsel GJ, Zondervan HA, Treffers PE. Risk factors for preeclampsia in nulliparous women in distinct ethnic groups: a prospective cohort study. Obstet Gynecol 1998;92:174-8.
13. Sibai BM, Lindheimer M, Hauth J, Caritis S, VanDorsten P, Klebanoff M et al. Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension. N Engl J Med 1998; 339:667-671.
14. Dekker GA, Sibai BM. Early detection of preeclampsia. Am J Obstet Gynecol 1991;165:160-172.
15. Caritis S, Sibai BM, Hauth J, Lindheimer M, VanDorsten P, Klebanoff M, et al. Predictors of pre-eclampsia in women at high risk. Am J Obstet Gynecol 1998;179:946-51.
16. Pijnenborg R. The placental bed. Hypertens Pregnancy 1996;15:7-23.
17. Zhou Y, Damsk CH, Fisher SJ. Preeclampsia is associated with failure of human cytotrophoblasts to mimic a vascular adhesion phenotype. J Clin Invest 1997; 99:2152-64.
18. Meekins JW. Pijnenborg R, Hanssens M, McFadyen IR, van Assche A. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynecol 1994;101:669-74.
19. Meekins JW, Pijnenborg R, Hanssens M, van Assche A, McFadyen IR. Immunohistochemical detection of lipoprotein in the wall of placental bed spiral arteries in normal and severe pre-eclamptic pregnancies. Placenta 1994;15:511-24.
20. Charnock Jones DS, Sharkey AM, Boocock CA, Ahmed A, Plevin R, Ferrara N, et al. Vascular endothelial growth factor receptor localization and activation in human trophoblast and choriocarcinoma cells. Biol Reprod 1994;41: 524-30.
21. Wheeler T, Elcock CL, Anthony FW. Angiogenesis and the placental environment. Placenta 1995;16:289-96.
22. Hofman GE, Glatsein I, Schatz F, Heller D, Deligdisch L. Immunohistochemical localization of urokinase-type palsminogen activator and the plasminogen activator inhibitors 1 and 2 in early human implantation sites. Am J Obstet Gynecol 1994;170:671-6.
23. Moll UM, Lane BL. Proteolytic activity of first trimester human placenta : localization of interstitial collagenase in villous and extravillous trophoblast. Histochemistry 1990;94:555-60.
24. Zhou Y, Damsky CH, Chiu K, Roberts JM, Fisher SJ. Preeclampsia is associated with abnormal expression of adhesion molecules by invasive cytotrophoblasts. J Clin Invest 1993;91:950-60.
25. Molnar M, Suto T, Toth T, Hertelendy F. Prolonged blockade of nitric oxide synthesis in gravid rats produces sustained hypertension, proteinuria, thrombocytopenia and intrauterine growth retardation. Am J Obstet Gynecol 1994;170:1458-66.
26. Pascoal IF, Umans JG. Effect of pregnancy on mechanisms of relaxation in human omental microvessels. Hypertension 1996;28:183-7.
27. Shanklin DR, Sibai BM. Ultrastructural aspects of preeclampsia. I. Placental bed and uterine boundary blood vessels. Am J Obstet Gynecol 1989;161:735-41.
28. Taylor RN, de Groot CJM, Cho YK, Lim KH. Circulating factors as markers and mediators of endothelial cell dysfunction in preeclampsia. Seminars in Reproductive Endocrinology. 1998;16:17-31.
29. Roberts JM. Endothelial dysfunction in preeclampsia. Seminars in Reproductive Endocrinololgy. 1998;16:5-15.
30. Fiers W. Tumor necrosis factor. Characterization at the molecular, cellular and in vivo level. FEBS 1991;285:199-212.
31. Stark JM. Pre-eclampsia and cytokine induced oxidative stress. Br J Obstet Gynecol 1993;100:105-109.
32. Toborek M, Barger SW, Mattson MP, Barve S, McClain CJ, Hennig B. Linoleic acid and TNF-α cross-amplify oxidative injury and dysfunction of endothelial cells. J Lipid Res 1996;37:123-135.
33. Beutler B, Cerami A. The biology of cachectin/TNF-α primary mediator of the host response. Annu Rev Immunol 1989;7:625-55.
34. Arai K, Lee F, Miyajima A, Miyatake S, Arai N, Yokota T. Cytokine: Coordinators of immune and inflammatory response. Annu Rev Biochem 1990;59:783-836.
35. Roberts JM, Redman CWG, Preclampsia : More than pregnancy-induced hypertension. Lancet 1993;341:1447-1451.
36. Tsukimori K, Ishida K, Maeda H, Koyanaki J, Nakano H, The placeta as possible source of the factor causing endothelial cell injury in preeclampsia. Hypertens Pregnancy 1994;13:358.
37. Potter JM, Nestel PJ. The hyperlipidemia of pregnancy in normal and complicated pregnancies. Am J Obstet Gynecol 1979;133:165-170.
38. Lorentzen B, Endresen MJ, Hovig T, Haug E, Henriksen. Sera from preeclamptic women increase the content of triglycerides and reduce the release of prostacyclin in cultured endothelial cells. Thromb Res 1991;63:363-372.
39. Arbogast BW, Lee GM, Raymond TL. In vitro injury of porcine aortic endothelilal cells by very low density lipoproteins from diabetic rat serum. Diabetes 1982;31:593-599.
40. Arbogast BW, Berry DL, Newell BC. Injury of arterial endothelial cells in diabetic, sucrose-fed and aged rats. Atherosclerosis 1984;51:31-45.
41. Goode GK, Miller JP, Heagerty AM. Hyperlipidemia, hypertension, and coronary heart disease. Lancet 1995;345:362-364.
42. Arbogast BW, Leeper SC, Merrick RD, Olive KE, Taylor RN. Which plasma factors bring about disturbance of endothelial function in preeclampsia? Lancet 1994;343:340-341.
43. Arbogast BW, Leeper SC, Merrick RD, Olive KE, Taylor RN. Plasma factors that determine endothelial cell lipid toxicity in vitro correctly identify women with preeclampsia in early and late pregnancy. Hypertens Pregnancy 1996;15:263-279.
44. Sattar N, Bendomir A, Berry C, Shepherd J, Greer IA, Packard CJ. Lipoprotein subfraction concentrations in preeclampsia: pathogenic parallels to atherosclerosis. Obstet Gynecol 1997;89:403-408.
45. Vigne J-L, Murai JT, Arbogast BW, Jia W, Fisher SJ, Taylor RN. Elevated nonesterified fatty acid concentrations in severe preeclampsia shift the isoelectric characteristics of plasma albumin. J Clin Endocrinol Metab 1997;82:3786-3792.
46. Campbell DM, MacGillivray I, Carr Hill R. Preeclampsia in secondary pregnancy. Br J Obstet Gynecol 1985;92:131-140.
47. van Beek E, Peeters LLH. Pathogenesis of preeclampsia: A comprehensive model. Obstet Gynecol Surv 1998;53:233-239.
48. Carosella ED, Dausset J, Kirszenbaum M. HLA-G revisited. Immunol Today 1996;17:407-9.
49. Colbern GT, Chiang MH, Main EK. Expression of the nonclassic histoco- mpatibility antigen HLA-G by preelamptic placenta. Am J Obstet Gynecol 1994;170:1244-50.
50. Loke YW, King A. Immunology of human placental implantation: clinical implications of our current understanding. Mol Med Today 1997;Apr:153-9.
51. Chesley LC, Annitto JE, Cosgrove RA. The familial factor in toxemia of pregnancy. Obstet Gynecol 1968;32:303-11.
52. Arngrimsson R, Connor JM, Geirsson RT, Brennecke S, Cooper DW. Is genetic susceptibility for preeclampsia and eclampsia associated with implantation failure and fetal demise? Lancet 1994;343:1643-4.
53. Kilpatrick DC, Gibson F, Livingston J, Liston WA. Preeclampsia is associated with HLA-DR4 sharing between mother and fetus. Tissue Antigens 1990;35:178-8.
54. Ward K, Hata A, Jeunemaitre X. A molecular variant of angiotensinogen associated with preeclampsia. Nature Genet 1993;4:59-61.
55. 조용균. 한국인 자간전증 임신부의 angiothesinogen exon 2 M235 유전자의 변이. 1995. 의학박사학위논문.
56. Widschwendter M, Schrocksnadel H, Mortl MG. Preeclampsia: a disorder of placental mitochondria? Mol Med Today 1998;July:286-291
57. Redman CWG, Sacks GP, Sargent IL. Preeclampsia: An excessive maternal inflammatory response to pregnancy. Am J Obstet Gynecol 1999;180:499-506.
58. Levine RJ, Hauth JC, Curet LB, Sibai BM, Catalano PM, Morris CD. et al. Trial of calcium to prevent preeclampsia. N Engl J Med 1997;337:69-76.
59. Collaborative Group: CLASP: A randomized trial of low-dose aspirin for the prevention and treatment of preeclampsia among 9364 pregnant women. Lancet 1994; 343:619-629.
60. Repke JT, Robinson JN. The prevention and management of preeclampsia and eclampsia. Int J Gynecol Obstet 1998;62:1-9.
61. Schiff E, Friedman SA, Sibai BM. Conservative management of severe preeclampsia remote from term. Obstet Gynecol 1994; 84: 626-630.
62. Linton DM, Anthony J. Critical care management of severe preeclampsia. Intensive Care Med 1997;23:248-255.
63. Hsueh WA. Preeclampsia and hypertension in pregnancy. Current Therapy in Endocrinology and Metabolism. 1997;6:324-327.
64. Witilin AG, Sibai BM. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol 1998;92:883-9.
65. Repke JT. Preeclampsia and hypertension. In: Repke JT, editor. Intrapartum Obstetrics. New York: Churchill Livingstone, 1996:253-273.
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