慢性阻塞性肺疾病的特点对妊娠并发症发生的影响

S. Heryak, O. Oleksiak
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摘要

近年来,慢性阻塞性肺疾病(COPD)在女性中的患病率越来越高,这也是科学家对COPD对孕妇的影响越来越感兴趣的原因之一。本研究旨在探讨慢性阻塞性肺病孕妇妊娠并发症的发展特点。材料和方法。对77例经临床和仪器验证有COPD症状的孕妇进行检查,并根据支气管阻塞程度分为2个亚组:IA - 43例FEV1≥80%的孕妇,IB - 34例FEV1 50-79%的孕妇。对照组为27名健康孕妇。细胞因子谱被确定,并与支气管阻塞程度和产科和围产期并发症的频率建立了相关的相互作用。结果。我们对慢性阻塞性肺疾病孕妇轻、中度支气管梗阻期的细胞因子谱指标分析显示,促炎因子(IL-1β、IL-6)水平明显升高,抗炎因子IL-10水平同时降低(p≤0.05)。我们发现支气管梗阻程度的增加与贫血等妊娠和分娩并发症的检出率也有较高的相关性,分别为3.1倍、早产威胁9倍、先兆子痫7倍、胎盘功能障碍3.4倍、宫内生长受限8倍、早产3.5倍、产程早破4倍。胎儿窘迫是对照组的3倍。结论。孕妇COPD的特点是细胞因子平衡的全身性紊乱,并伴有产科和围产期并发症的频率显著增加,其频率取决于支气管阻塞的程度。
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THE FEATURES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE INFLUENCE ON THE PREGNANCY COMPLICATIONS DEVELOPMENT
In recent years, the prevalence of chronic obstructive pulmonary disease (COPD) has been increasingly observed among women, which is one of the reasons for the higher interest of scientists in the influence of COPD on pregnant woman. The aim of our study was to establish the features of the development pregnancy complications in pregnant women with COPD. Materials and methods. 77 pregnant women with clinically and instrumentally verified signs of COPD were examined and were divided into 2 subgroups depending on the degree of bronchial obstruction: IA - 43 pregnant women with FEV1≥80%, IB - 34 pregnant women with FEV1 50-79%. The control group consisted of 27 healthy pregnant women. The cytokine profile was determined and a correlational interaction with the degree of bronchial obstruction and the frequency of obstetric and perinatal complications was established. The results. Our analysis of cytokine profile indicators in pregnant women with chronic obstructive pulmonary disease at the stage of mild and moderate bronchial obstruction showed a characteristic and reliable increase in the level of pro-inflammatory cytokines (IL-1β, IL-6) and a simultaneous decrease in the level of anti-inflammatory IL-10 (p≤0.05). We established that an increase in the degree of bronchial obstruction is also associated with a higher frequency of detection of such pregnancy and childbirth complications as anemia, respectively, by 3.1 times, the threatened of premature birth by 9 times, preeclampsia by 7 times, placental dysfunction by 3.4 times, intrauterine growth restriction 8 times, premature birth 3.5 times, premature rupture of membranes during labor 4 times, and fetal distress 3 times higher compared to the control group. Conclusions. COPD in pregnant women is characterized by systemic disturbances in the cytokine balance and is accompanied by a significant increase in the frequency of obstetric and perinatal complications, the frequency of which depends on the degree of bronchial obstruction.
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Pharmacy World & Science
Pharmacy World & Science 医学-药学
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