【好文推荐】子痫前期早期预防监测要点
在《母胎医学杂志（英文）》2021年第二期中，王伽略老师、杨孜老师共同发表了题为"子痫前期早期预防监测要点"的述评，介绍了中国及杨孜教授领导的工作组在子痫前期预防方面的研究、策略和成果。作者信息与中英文摘要如下：
北京大学第三医院妇产科副主任医师
王伽略北京大学第三医院妇产科主任医师，博士生导师
杨孜Key Points to Early Action for Preventing and Monitoring the Syndrome of Preeclampsia
Author: Wang, Jialue; Yang, Zi
Citation: Wang J, Yang Z. Key Points to Early Action for Preventing and Monitoring the Syndrome of Preeclampsia. Maternal Fetal Med 2021;3(2):81–86. doi: 10.1097/FM9.0000000000000100.
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Abstract
Over the years, the research group led by Yang Zi has pointed out that the etiology and pathogenesis of preeclampsia syndrome are characterized by multifactorial, involving numerous mechanisms, numerous pathways, and organ systems. In depth understanding of these characteristics can expand the understanding of the syndrome of preeclampsia, and carry out the effective prevention and monitoring in clinical practice. The first step to early action in preventing and monitoring preeclampsia starts from pre-pregnancy consultation and prenatal care in every step. Early screening and intervention should be prioritized at the first visit during peri-pregnancy period for primary prevention.The quality of prenatal care and close monitoring of dietary, nutritional, and environmental factors should be prioritized during pregnancy management. Early warning signs and early isolated symptoms should not be overlooked but contribute to the early detection and diagnosis and intervention of preeclampsia. Early warning signs associated with serious complications of preeclampsia should be intervened during the management of preeclampsia. A hierarchical and classification approach should be carried out by “Bu Bu Wei Ying,” which means, advancing gradually and entrenching oneself at every step, and “Ceng Ceng She Fang,” which means, set up successive lines of defense. The important thing is to implement every step of practical measures. Using these methods, preventative strategies can be employed before or at the onset of preeclampsia or during disease progression, ultimately reducing the incidence of maternal and fetal mortality and morbidity in this population.
摘要
杨孜教授领导的研究组提出子痫前期综合征的病因和发病机制存在多因素、多机制和多通路的特点。深入了解这些特点能拓展对子痫前期的认识，并在临床实践中进行预防和监测。预防和监测子痫前期早期行动的重点包括孕前咨询和产前保健过程的各个环节。首先，应在围孕期第一次就诊时进行早期筛查和干预，以实现初级预防。在产前保健过程中，应重视产前保健的质量，以及对饮食、营养和环境因素进行密切监测。子痫前期的早期预警信号和早期单发症状不容忽视，这有助于子痫前期的早期发现、诊断和干预。而且，不能忽视对子痫前期严重并发症的早期预警信号，且应在子痫前期治疗过程中同时加以干预。以“步步为营”和“层层设防”的方法，逐步推进，落实切实可行的防控措施，以建立预防和监测子痫前期的连续防线，可以最终降低该人群的母婴死亡率和发病率。
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