系统评价妊娠期糖尿病胎盘差异表达蛋白对胎儿的影响  

Effects of differentially expressed proteins in placenta of patients with gestational diabetes mellitus on fetus: a systematic review

作　　者：黄萍萍 葛莉[1] 缪海燕[2] 郑清香[1] 王冠东 于红虹[1] HUANG Ping-Ping;GE Li;MIAO Hai-Yan(Nursing School,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学护理学院,福建福州350122 [2]福建中医药大学附属第二人民医院妇产科,福建福州350003

出　　处：《中国妇幼保健》2020年第6期1162-1167,共6页Maternal and Child Health Care of China

基　　金：福建省自然科学基金资助项目(2018J01868);福建中医药大学2017年校管课题重点专项(X2017011-重点)。

摘　　要：目的系统评价妊娠期糖尿病胎盘差异表达蛋白对胎儿的影响。方法于2019年6月计算机检索PubMed、Web of Science、Cochrane Library、EMBase、Medline (Ovid)、Scopus、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普中与妊娠期糖尿病胎盘蛋白表达有关的文献,检索时限为2010年1月-2019年6月。采用主题词与自由词结合的方式进行检索,同时手工检索相关文献的参考文献。运用纽卡斯尔渥太华量表评价纳入研究的方法学质量,进行描述性分析。结果最终纳入15篇文献,均为病例对照研究,共包含844名研究对象。系统评价结果显示:胎盘差异表达蛋白通过干扰葡萄糖、脂质代谢与转运,影响氨基酸转运和蛋白质合成,调整胎盘屏障,增加水、甘油和铁转运4个途径影响胎儿生长发育和妊娠结局。结论胎盘蛋白表达失调可能介导胎盘营养转运能力的改变和影响胎盘屏障,参与胎儿宫内生长发育和增加不良胎儿结局的风险。但其因果关系及调控机制尚不明确,有待进一步深入研究。Objective To systematically assess the effects of differentially expressed proteins in placenta of patients with gestational diabetes mellitus on fetus. Methods In June 2019,relevant literatures reporting placental protein expression in patients with gestational diabetes mellitus were identified by computer-searching in PubMed,Web of Science,Cochrane Library,EMBase,Medline( Ovid),Scopus,CBMdisc,CNKI,Wanfang Database,and VIP from January 2010 to June 2019. The search was conducted using mesh terms combined with free words,relevant references were searched manually. The methodological quality was assessed by Newcastle Ottawa Scale,a descriptive analysis was performed. Results Finally,15 case-control studies involving 844 cases were included. The results of systematic review showed that: placental differentially expressed proteins affected fetal growth and pregnancy outcomes in four aspects,including interfering with glucose,lipid metabolism and transport;affecting the progress of amino acid transport and protein synthesis;adjusting placental barrier;increasing the transport of water,glycerol,and iron. Conclusion Deregulation of placental protein expression may mediate changes of placental nutrient transport capacity and affect placental barrier,participate in intrauterine growth,and increase the risk of adverse fetal outcomes. However,the causal relationship and regulation mechanism are still unclear and need further study.

关 键 词：妊娠期糖尿病 胎盘蛋白 胎儿 系统评价 

分 类 号：R714.256[医药卫生—妇产科学]