血管损伤因子与子痫前期发病机制的研究

Advances About Vascular Injury Factors in the Pathogenesis of Preeclampsia

子痫前期是妊娠妇女和围生儿死亡的主要原因之一,迄今病因仍未明了。目前研究认为,内皮细胞损伤、血管生成抑制和血管间炎症在其发病中起重要作用。一些胎盘及血管源性循环因子的释放,包括血管内皮生长因子、可溶性血管内皮生长因子-1、血管紧张素Ⅱ受体1的自身抗体及肿瘤坏死因子-α、白细胞介素1(IL-1)和IL-6、正五聚蛋白3等通过不同途径引起母体血管内皮广泛损伤及全身性炎症反应;血管舒缩因子失衡,例如一氧化氮(NO)、前列环素及肾上腺髓质素等血管舒张因子表达减少,而内皮素、血管紧张素Ⅱ等血管收缩因子表达增加也可导致血管功能紊乱。其中某些标记物还可作为子痫前期发病的预测指标。

Pre-eclampsia is a leading cause of death of the pregnant women and the perinatal fetus,but the cause has not been clear.Present study suggests that endothelial cell injury,angiogenesis inhibition and vascular inflammation are very important in the pathogenesis.The release of some factors of placenta and blood vessel-derived circulating factors,including VEGF,sFlt-1,AT1-AA,TNF-a,IL-1,IL-6,PTX3 can cause vascular endothelial extensive damage and systemic inflammatory response by various means.Vasomotor factor imbalance,the decreasing expression of vascular relaxing factor such as NO、prostacyclin、adrenomedullin and the increasing expression of vascular contraction factor such as angiotensin Ⅱ、endothelin can also lead to vascular dysfunction.Some of these markers also serve as a predictor of preeclampsia incidence.