妊娠中期巨细胞病毒感染加重致慢性胎盘功能不全形成过程中子宫动脉血流调节的机制

I. Gorikov
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Subgroup 1 included 30 women with exacerbation of CMVI, initiating the development of chronic compensated placental insufficiency (CCPI), subgroup 2 − 30 patients with acute phase of chronic CMVI, leading to the formation of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.Results. In women of the 1st group in the blood serum, the concentration of IL-1β (Me [Q1- Q3]) was 18.0 [13.4-36.3] pg/mL, IFN-γ − 134.4 [114.2-151.3] pg/mL, IL-4 − 26.2 [20.3-51.3] pg/mL and IL-2 − 27.9 [18.2-38.0] pg/mL; SDR in RUA – 1.95 [1.87-2.30] relative units and SDR in LUA – 1.84 [1.73-2.25] relative units. In patients of subgroup 1, in comparison with the control one, the concentration of IL-1β increased to 87.3 [55.6-98.2] pg/mL (p=0.000001), IFN-γ − up to 237.3 [191.4-318.6] pg/mL (p=0.000001) and IL-2 − up to 77.1 [58.6-92.3] pg/mL (p=0.000001) in the absence of statistically significant changes IL-4 level. There was an increase in SDR in RUA up to 2.45 [2.35-3.46] relative units (p=0.000001) and SDR in LUA up to 2.80 [2.31-3.05] relative units (p=0.000001). In subgroup 2, in comparison with subgroup 1, higher values of IL-1β were recorded (1.67 times, p=0.000001), IFN-γ (1.38 times, p=0.000015), IL-2 (1.36 times, p=0.00808), SDR in RUA (by 1.35 times, p=0.0105) and SDR in the LUA (by 1.08 times, p=0.0307), as well as a decrease in the level of IL-4 (by 1.84 times, p=0.000002). In women of subgroup 1, there was a direct relationship between the level of IL-1β, IFN-γ, IL-2 and SDR in the RUA (r=0.54, p<0.01; r=0.74, p<0.001 and r=0.58, p<0.001, respectively). The correlation between IFN-γ and SDR in the LUA was determined (r=0.40; p<0.05). In subgroup 2, there was a relationship between IL-4 and SDR in RUA (r=-0.59; p<0.001), as well as IL-2 and SDR in RUA (r=0.39; p<0.05). A correlation was recorded between the concentration of IL-1β, IFN-γ, IL-2 and the SDR value in the LUA (r=0.39, p<0.05; r=0.58, p<0.001 and r=0.57, p<0.001, respectively).Conclusion. Exacerbation of CMVI in women in the second trimester of gestation, leading to the formation of CSPI, in contrast to a similar viral infection that initiates the development of CCPI in the third trimester of pregnancy, is characterized by a more pronounced activation of the systemic inflammatory response, an increase in resistance to blood flow, as well as differences in immuno-hemodynamic relationships that determine the maintenance of vascular tone in the basin of the right and left uterine arteries.","PeriodicalId":9598,"journal":{"name":"Bulletin Physiology and Pathology of Respiration","volume":"104 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Mechanisms of blood flow regulation in the uterine arteries during the formation of chronic placental insufficiency caused by exacerbation of cytomegalovirus infection during the second trimester of gestation\",\"authors\":\"I. 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引用次数: 1

摘要

的目标。探讨巨细胞病毒感染(CMVI)加重致妊娠中期慢性胎盘功能不全形成过程中子宫动脉血流调节的机制。材料和方法。测定90例未合并CMVI和合并CMVI加重的妊娠中期妇女子宫右动脉(RUA)和左动脉(LUA) IL-1β、IFN-γ、IL-4、IL-2浓度及收缩压舒张比(SDR)。回顾性分析,分为两组。第1组(对照组)为cmv血清阴性生理性妊娠妇女30例,第2组(主要组)为慢性CMVI急性期患者60例,分为第1和第2亚组。亚组1包括30例CMVI加重的妇女,开始发展为慢性代偿性胎盘功能不全(CCPI),亚组2 - 30例慢性CMVI急性期,导致妊娠晚期形成慢性亚代偿性胎盘功能不全(CSPI)。第一组妇女血清中IL-1β (Me [Q1- Q3])浓度为18.0 [13.4-36.3]pg/mL, IFN-γ - 134.4 [114.2-151.3] pg/mL, IL-4 - 26.2 [20.3-51.3] pg/mL, IL-2 - 27.9 [18.2-38.0] pg/mL;SDR在RUA - 1.95[1.87-2.30]相对单位和SDR在LUA - 1.84[1.73-2.25]相对单位。在1亚组患者中,与对照组相比,IL-1β浓度升高至87.3 [55.6-98.2]pg/mL (p=0.000001), IFN-γ−高达237.3 [191.4-318.6]pg/mL (p=0.000001), IL-2−高达77.1 [58.6-92.3]pg/mL (p=0.000001), IL-4水平无统计学意义变化。RUA的SDR增加了2.45[2.35-3.46]相对单位(p=0.000001), LUA的SDR增加了2.80[2.31-3.05]相对单位(p=0.000001)。在亚组2中,与亚组1相比,IL-1β升高(1.67倍,p=0.000001), IFN-γ升高(1.38倍,p=0.000015), IL-2升高(1.36倍,p=0.00808), RUA中SDR升高(1.35倍,p=0.0105), LUA中SDR升高(1.08倍,p=0.0307), IL-4降低(1.84倍,p=0.000002)。亚组1女性RUA中IL-1β、IFN-γ、IL-2水平与SDR有直接关系(r=0.54, p<0.01;R =0.74, p<0.001; R =0.58, p<0.001)。确定LUA中IFN-γ与SDR的相关性(r=0.40;p < 0.05)。在亚组2中,IL-4与RUA中SDR存在相关性(r=-0.59;p<0.001),以及RUA中IL-2和SDR的差异(r=0.39;p < 0.05)。LUA中IL-1β、IFN-γ、IL-2浓度与SDR值存在相关性(r=0.39, p<0.05;r=0.58, p<0.001; r=0.57, p<0.001)。妊娠中期妇女CMVI的恶化导致CSPI的形成,与在妊娠晚期启动CCPI发展的类似病毒感染相反,其特征是全身炎症反应的激活更明显,对血流的抵抗力增加。以及决定左右子宫动脉盆区血管张力维持的免疫-血流动力学关系的差异。
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Mechanisms of blood flow regulation in the uterine arteries during the formation of chronic placental insufficiency caused by exacerbation of cytomegalovirus infection during the second trimester of gestation
Aim. To evaluate the mechanisms of regulation of blood flow in the uterine arteries during the formation of chronic placental insufficiency caused by an exacerbation of cytomegalovirus infection (CMVI) in the second trimester of pregnancy.Materials and methods. The concentration of IL-1β, IFN-γ, IL-4, IL-2 and the systolic-diastolic ratio (SDR) in the right (RUA) and left uterine arteries (LUA) were determined in 90 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of CMVI. Retrospectively, 2 groups were distinguished. Group 1 (control) was represented by 30 women with CMV-seronegative physiological pregnancy, group 2 (main) included 60 patients with acute phase of chronic CMVI and consisted of subgroups 1 and 2. Subgroup 1 included 30 women with exacerbation of CMVI, initiating the development of chronic compensated placental insufficiency (CCPI), subgroup 2 − 30 patients with acute phase of chronic CMVI, leading to the formation of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.Results. In women of the 1st group in the blood serum, the concentration of IL-1β (Me [Q1- Q3]) was 18.0 [13.4-36.3] pg/mL, IFN-γ − 134.4 [114.2-151.3] pg/mL, IL-4 − 26.2 [20.3-51.3] pg/mL and IL-2 − 27.9 [18.2-38.0] pg/mL; SDR in RUA – 1.95 [1.87-2.30] relative units and SDR in LUA – 1.84 [1.73-2.25] relative units. In patients of subgroup 1, in comparison with the control one, the concentration of IL-1β increased to 87.3 [55.6-98.2] pg/mL (p=0.000001), IFN-γ − up to 237.3 [191.4-318.6] pg/mL (p=0.000001) and IL-2 − up to 77.1 [58.6-92.3] pg/mL (p=0.000001) in the absence of statistically significant changes IL-4 level. There was an increase in SDR in RUA up to 2.45 [2.35-3.46] relative units (p=0.000001) and SDR in LUA up to 2.80 [2.31-3.05] relative units (p=0.000001). In subgroup 2, in comparison with subgroup 1, higher values of IL-1β were recorded (1.67 times, p=0.000001), IFN-γ (1.38 times, p=0.000015), IL-2 (1.36 times, p=0.00808), SDR in RUA (by 1.35 times, p=0.0105) and SDR in the LUA (by 1.08 times, p=0.0307), as well as a decrease in the level of IL-4 (by 1.84 times, p=0.000002). In women of subgroup 1, there was a direct relationship between the level of IL-1β, IFN-γ, IL-2 and SDR in the RUA (r=0.54, p<0.01; r=0.74, p<0.001 and r=0.58, p<0.001, respectively). The correlation between IFN-γ and SDR in the LUA was determined (r=0.40; p<0.05). In subgroup 2, there was a relationship between IL-4 and SDR in RUA (r=-0.59; p<0.001), as well as IL-2 and SDR in RUA (r=0.39; p<0.05). A correlation was recorded between the concentration of IL-1β, IFN-γ, IL-2 and the SDR value in the LUA (r=0.39, p<0.05; r=0.58, p<0.001 and r=0.57, p<0.001, respectively).Conclusion. Exacerbation of CMVI in women in the second trimester of gestation, leading to the formation of CSPI, in contrast to a similar viral infection that initiates the development of CCPI in the third trimester of pregnancy, is characterized by a more pronounced activation of the systemic inflammatory response, an increase in resistance to blood flow, as well as differences in immuno-hemodynamic relationships that determine the maintenance of vascular tone in the basin of the right and left uterine arteries.
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