综述
子痫前期的病理生理研究进展
谢青贞
漆倩荣
徐望明
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DOI: 10.3760/cma.j.issn.0529-567X.2015.12.015
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摘要

子痫前期是指在妊娠20周及以后新出现的高血压和蛋白尿的综合征,或无蛋白尿,但存在多系统功能障碍的疾病,如血小板计数减少、肝肾功能不全、肺水肿和脑血管意外等。子痫前期在妊娠妇女中的发病率为3%~5%,是导致孕妇和围产儿死亡的主要原因 [ 1 ] 。子痫前期可导致胎儿生长受限(FGR)和早产,或发展为子痫,是产科的危急重症,严重威胁母儿的生命安全 [ 1 ]

引用本文

谢青贞,漆倩荣,徐望明. 子痫前期的病理生理研究进展[J]. 中华妇产科杂志,2015,50(12):949-953.

DOI:10.3760/cma.j.issn.0529-567X.2015.12.015

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子痫前期是指在妊娠20周及以后新出现的高血压和蛋白尿的综合征,或无蛋白尿,但存在多系统功能障碍的疾病,如血小板计数减少、肝肾功能不全、肺水肿和脑血管意外等。子痫前期在妊娠妇女中的发病率为3%~5%,是导致孕妇和围产儿死亡的主要原因 [ 1 ]。子痫前期可导致胎儿生长受限(FGR)和早产,或发展为子痫,是产科的危急重症,严重威胁母儿的生命安全 [ 1 ]
近20年来,人们对子痫前期的认识从简单的妊娠期高血压,逐渐深入到子痫前期的病理生理机制。目前认为,子痫前期发生的根本原因是胎盘缺血,并与炎症反应、应激反应、血管和内皮细胞功能障碍有关,最终导致孕妇的妊娠生理状态改变,出现高血压、蛋白尿及其他系统功能紊乱等临床表现 [ 2 ]。目前,子痫前期的临床治疗措施有限,重点是控制急性高血压、预防子痫和及时分娩,唯一有效的治疗方法是将胎儿和胎盘娩出,因此,子痫前期的预防和早期预测尤为重要。大量研究认为,子痫前期的病理生理改变在临床症状出现之前既已存在,深入了解子痫前期的发病机制,可为临床上预测和预防子痫前期提供指导,避免孕产妇出现严重的并发症,改善妊娠结局。本文综述了近年来关于子痫前期发病机制的研究进展,着重讨论子痫前期发生的病理生理机制。
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