摘要
子痫前期是一种严重的具有不同临床表现的多系统疾病。目前研究发现,虽然没有明确的因果关系,内皮功能障碍以及一氧化氮生物利用度的降低可能会在发病的病理生理学中发挥重要作用。缺乏可以针对潜在的病理生理变化和逆转内皮功能障碍的治疗方法,往往会导致胎儿的医源性早产,引起新生儿发病率和死亡率的增高,以及产妇发病率和死亡率的增加。针对一氧化氮—可溶性鸟苷酸环化酶途径的各成分的药物可以有助于增加NO的生物利用度。此综述的目的是概述子痫前期在临床研究的治疗方法,重点是对一氧化氮供体包括有机硝酸盐和S-亚硝基硫醇,L-精氨酸,NO内源性前体;c GMP的分解抑制剂,包括西地那非,以及NO供体代谢新型抑制剂等。本研究概述了每种治疗模式的优点和局限性,并且对于子痫前期的既定治疗方案进行了探索。
Pre-eclampsia is a serious multisystem disorder with diverse clinical manifestations. Researches have shown that endothelial dysfunction and reduced nitric oxide bioavailability are likely to play an important role in the maternal and fetal pathophysiology. Lack of treatment modalities that can target the underlying pathophysiological changes and reverse the endothelial dysfunction frequently leads to iatrogenic preterm delivery of the fetus, causing neonatal morbidity and mortality, and maternal morbidity and mortality. Drugs that target various components of the nitric oxide： soluble guanylyl cyclase pathway can help to increase NO bioavailability. The purpose of this review is to outline the current status of clinical research involving these therapeutic modalities in the context of preeclampsia, with the focus being on nitric oxide donors including organic nitrates and S-nitrosothiols; L-arginine, the endogenous precursor of NO;inhibitors of cGMP breakdown including sildenafil, and other novel inhibitors of NO donor metabolism. The advantages and limitations of each modality are outlined and the development into established therapeutic options for preeclampsia is explored.
出处
《中国医药科学》
2015年第8期25-28,39,共5页
China Medicine And Pharmacy
