子痫前期发病机制的研究进展

Progress on the Pathogenesis of Pre-eclampsia

子痫前期（preeclampsia,PE）是妊娠中晚期特有的多脏器损害性疾病,其发生率约为5%~8%,其特征是妊娠20周后出现血压升高、蛋白尿和水肿,进而可能会导致胎盘早剥、弥漫性血管内凝血（DIC）、子痫、HELLP综合征（血小板减少、肝酶升高和溶血）、肾功能衰竭、脑血管意外等严重并发症的发生,病情严重时可发展为子痫及多脏器功能衰竭,是导致孕产妇及围生儿死亡的主要原因之一. 其主要的病理基础是各种病因导致血管内皮细胞的损伤,继而多种血管活性因子、炎性因子和凝血因子调节异常,从而出现多脏器功能损害. 关于其发生机制主要有胎盘或滋养细胞缺血缺氧学说、氧化应激学说、免疫调节异常学说、遗传学说和血管内皮损伤学说等. 随着对PE的深入研究,对其发病机制也有了新的认识.

Pre-eclampsia （PE） is a disease with 5%-8%incidence and is traditionally diagnosed by the characteristic of high blood pressure, proteinuria and edema after 20 weeks of pregnancy combined with multiple organ failure. It may lead to placental abruption, DIC, eclampsia, HELLP syndrome （thrombocytopenia, elevated liver enzymes and hemolysis ）, renal failure, cerebral vascular accident and other serious complications, serious illness may develop eclampsia and multiple organ failure. PE is one of the main causes of maternal and perinatal child mortality. The main pathological basis is the various etiologies leading to endothelial cell damage, followed by a variety of vasoactive factors, inflammatory factors and clotting factor dysregulation, which appeared multiple organ dysfunction. There are placental trophoblast cell ischemia and hypoxia or doctrine, the doctrine of oxidative stress, immune dysregulation theory, genetics, and vascular endothelial damage theory and so on accounting for its mechanism. With further research on PE, is also has a new understanding to its pathogenesis.