生物活性因子在妊娠期高血压疾病发病机制中的作用  

The Role of Biologically Active Factors in the Pathogenesis of Hypertension in Pregnancy

作　　者：周文哲 曲洪美(审校)[2] ZHOU Wen-zhe;QU Hongmei(Binzhou Medical University,Yantai 264003,Shandong Province,China;Department of Obstetrics,Yantai Yuhuangding Hospital,Yantai 264010,Shandong Province,China)

机构地区：[1]滨州医学院,山东省烟台市264003 [2]烟台毓璜顶医院产科

出　　处：《国际妇产科学杂志》2021年第4期361-366,共6页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金(81601288)。

摘　　要：妊娠期高血压疾病(hypertensive disorder complicating pregnancy,HDCP)是妊娠和高血压并存的一组疾病,是严重的妊娠期并发症,病因和发病机制目前尚未完全阐明。目前研究认为内在遗传因素与外在环境因素相互作用导致胎盘缺氧缺血是HDCP发病的主要机制。胎盘缺血缺氧促进生物活性因子释放到母体循环,一方面导致全身重要器官(脑、肾、肝)血管内皮增生、痉挛,从而引发高血压、蛋白尿、脑水肿和子痫等一系列的临床表现;另一方面生物活性因子抑制细胞外基质的降解,导致血管重塑能力不足,增加血管动脉硬化,血管阻力增加而加重胎盘缺血缺氧,引发HDCP循环往复。参与HDCP发病机制的生物活性因子主要有以下3种:抗血管生成因子、促血管生成因子和促炎性因子。结合近年来国内外文献,重点介绍3种活性因子在HDCP发病机制中的作用,为HDCP早期预测、早期诊断提供夯实的理论依据。Hypertensive disorder complicating pregnancy(HDCP) is a group of diseases that coexist with pregnancy and hypertension, and are serious complications of pregnancy. The etiology and pathogenesis have not yet been fully elucidated.Current researches believe that the interaction of internal genetic factors and external environmental factors leading to placental hypoxia-ischemia is the main mechanism of HDCP. Placental ischemia and hypoxia promote the release of biologically active factors into the maternal circulation. On the one hand, it causes vascular endothelial hyperplasia and spasm in important organs of the body(brain, kidney, liver), leading to hypertension, proteinuria, cerebral edema, eclampsia, etc. On the other hand,biologically active factors inhibit the degradation of extracellular matrix, leading to insufficient vascular remodeling ability,increasing vascular arteriosclerosis, increasing vascular resistance and aggravating placental ischemia and hypoxia, triggering HDCP cycles. There are three main biologically active factors involved in the pathogenesis of HDCP: anti-angiogenic factors,pro-angiogenic factors and pro-inflammatory factors. This article combines recent domestic and foreign literature, focusing on the role of three active factors in the pathogenesis of HDCP, and provides a solid theoretical basis for early prediction and early diagnosis of HDCP.

关 键 词：高血压 妊娠性 先兆子痫 血管内皮生长因子类 细胞因子类 促血管生成因子 抗血管生成因子 

分 类 号：R714.246[医药卫生—妇产科学]