妊娠中毒症の発症予防に関する臨床的,基礎的検討 : 低用量アスピリン療法を中心として

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Although preeclampsia is one of the major causes of maternal and perinatal death and an important issue in the obstetric field, its etiology is still unknown. The present study was undertaken to investigate the preventive effects of low-dose aspirin (LDA) started in early pregnancy on the repeated occurrence of preeclampsia. In addition, transforming growth factor-β (TGF-β), which is released by platelet aggregation, was added to cultures of isolated placental cells collected in early pregnancy to examine their effects on fetal fibronectin (FFN) and plasminogen activator inhibitor 1 (PAI-1). The subjects were 64 pregnant women with a history of preeclampsia. They were divided into a group of women managed in the routine manner (n=47, the control group) and a group of women treated with LDA (81 mg of pediatric Bufferin^[○!R]) from approximately 16 to 36 weeks pregnancy (n=17, LDA group). Severe preeclampsia recurred in 25 women (53.2%) in the control group, as opposed to only 4 women (23.5%) in the LDA group, revealing a significant preventive effect of LDA against preeclampsia (p <0.05) . When 10～100 ng/ml of TGF-β was added to the villous or decidual cells in culture, FFN production was significantly greater in the villous cells (p <0.05, p <0.01). TGF-β also significantly increased both FFN and PAI-1 in a dose-dependent manner in the decidual cells in culture (p <0.01). These findings suggest that promotion of platelet aggregation and a local increase in TGF-β in the placenta may contribute to the occurrence of preeclampsia, and that LDA may have a preventive effect against preeclampsia through suppresion of TGF-β from the platelets.
東京女子医科大学の論文
1997-12-25

妊娠中毒症の発症予防に関する臨床的,基礎的検討 : 低用量アスピリン療法を中心として

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