homéostasie du calcium

homeostasie du 钙
  • 文章类型: Systematic Review
    目的:对孕妇的管理没有具体建议:本综述的目的,根据临床案例研究,是为了澄清它的发展,并发症,危险因素和治疗。
    方法:通过咨询Pubmed,科克伦图书馆,和科学直接数据库。
    结果:原发性甲状旁腺功能亢进定义为甲状旁腺激素的过量产生导致高钙血症。妊娠期原发性甲状旁腺功能亢进的患病率尚不清楚。的确,症状学,与高钙血症有关,不是很具体,容易与妊娠的临床表现混淆。特定于妊娠状态的生理变化经常导致轻微的低钙血症,这可能使原发性甲状旁腺功能亢进的诊断复杂化。在大多数情况下,原发性甲状旁腺功能亢进是由甲状旁腺腺瘤引起的,并且在怀孕期间通过超声检测到。妊娠期原发性甲状旁腺功能亢进会对母亲和胎儿造成重大风险。产妇并发症发生率为14-67%,然而,最严重的并发症是高血钙危象,这需要在产后加强监测。原发性甲状旁腺功能亢进也会引起产科并发症,如急性羊水过多,或宫内发育迟缓。以新生儿低钙血症为主要并发症的病例,胎儿并发症发生率可达45~80%。如果药物治疗是基于过度水合,只有手术治疗才有疗效。
    结论:对于有症状的患者或有高血钙水平的患者,应建议进行手术。在跨学科委员会进行讨论,并应在妊娠中期进行理想的组织,以避免孕产妇和胎儿并发症。
    OBJECTIVE: There is no specific recommendation for management in pregnant women: the aim of this review, based on a clinical case study, is to clarify its development, complications, risk factor and treatment.
    METHODS: A review of the literature was performed by consulting the Pubmed, Cochrane Library, and Science Direct databases.
    RESULTS: Primary hyperparathyroidism is defined as excessive production of parathyroid hormone resulting in hypercalcemia. The prevalence of primary hyperparathyroidism during pregnancy is not known. Indeed, the symptomatology, related to hypercalcemia, is not very specific and easily confused with the clinical manifestations of pregnancy. The physiological changes specific to the pregnant state frequently lead to a slight hypocalcemia which may complicate the diagnosis of primary hyperparathyroidism. Primary hyperparathyroidism results from a parathyroid adenoma in the majority of cases and is detected by ultrasound during pregnancy. Primary hyperparathyroidism in pregnancy causes significant risks to both mother and fetus. The maternal complication rate is 14-67%, however, the most serious complication is hypercalcemic crisis, which requires increased surveillance in the postpartum period. Obstetrical complications are also induced by primary hyperparathyroidism, such as acute polyhydramnios, or intrauterine growth retardation. The fetal complication rate can reach 45-80% of cases with neonatal hypocalcemia as the main complication. If medical treatment is based on hyperhydration, only surgical treatment is curative.
    CONCLUSIONS: Surgery should be proposed to symptomatic patients or those with high blood calcium levels, discussed in interdisciplinary committee and should be organized ideally in the second trimester to avoid maternal and fetal complications.
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  • 文章类型: Journal Article
    在这项研究中,我们想验证胰岛素对钙稳态的影响是否取决于心脏的发育阶段。使用定量3D共聚焦显微镜,我们测试了高胰岛素浓度(100µU)对新生和成年大鼠心室心肌细胞的影响.我们的结果表明,与成年心肌细胞相比,新生心肌细胞的胞浆基础钙水平较高,而细胞核基础钙水平没有变化;此外,胰岛素诱导新生心室心肌细胞胞浆和细胞核钙的缓慢增加,其次是两个阶段。然而,成年大鼠心室心肌细胞中不存在第一阶段缓慢的胞浆和核钙增加。此外,与成人相比,新生心肌细胞胞浆和细胞核钙开始升高的时间更长.此外,新生儿钙瞬变达到峰值的时间比成人心肌细胞短。这些结果表明,与成年心肌细胞相比,胰岛素对新生儿钙稳态的调节方式不同。因此,新生大鼠心肌细胞,通常在研究中用作成人心肌细胞的模型,在正常和疾病情况下处理胰岛素时应谨慎使用。
    In this study, we wanted to verify whether the effect of insulin on calcium homeostasis depends on the heart\'s development stage. Using a quantitative 3D confocal microscopy, we tested the effect of a high insulin concentration (100 µU) in freshly cultured ventricular cardiomyocytes from newborn and adult rats. Our results showed that the cytosolic basal level of calcium was higher in newborn cardiomyocytes with no change in the nuclear basal calcium level compared with the adult cardiomyocytes; in addition, insulin induced a slow increase of cytosolic and nuclear calcium in newborn ventricular cardiomyocytes, followed by two phases. However, the first phase of slow cytosolic and nuclear calcium increase was absent in adult rat ventricular cardiomyocytes. Furthermore, the time to the onset of increase of cytosolic and nuclear calcium was longer in newborn cardiomyocytes compared with adults. Moreover, the time to peak of the calcium transient was shorter in newborns than in adult cardiomyocytes. These results demonstrate that insulin differently regulates calcium homeostasis in newborns than in adult cardiomyocytes. Thus, newborn rat cardiomyocytes, commonly used in research as a model for adult cardiomyocytes, should be used with caution when dealing with insulin in normal and disease conditions.
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