双胎妊娠合并子痫前期发病机制及预测方法研究进展

doi:10.12280/gjfckx.20240630

摘要/Abstract

摘要：

子痫前期（preeclampsia，PE）是一种常见的孕产妇并发症，与不良母婴结局密切相关。双胎妊娠作为PE发生的重要危险因素之一，其合并PE的发病机制与单胎妊娠有所相同，可能与胎盘体积大、容量负荷增加、血管内皮损伤、氧化应激及免疫机制等有关，表现出发病时间提前但病情较轻的特点。然而目前双胎妊娠发生PE的机制尚不明确，其特殊高危因素包括辅助生殖技术和绒毛膜性。临床上针对双胎妊娠合并PE多依赖于单一的预测指标，如可溶性fms样酪氨酸激酶-1（sFlt-1）、胎盘生长因子（PlGF）、妊娠相关血浆蛋白A（PAPP-A）或超声指标，因建模的样本量不足等缺陷，现有各预测指标的预测效能仍需检验，且需要更大样本量的研究探索双胎妊娠合并PE的最佳预测模型，进而指导临床决策。

关键词: 先兆子痫, 妊娠, 双胎, 发病机制, 预测, 临床决策

Abstract:

Preeclampsia(PE) constitutes a prevailing maternal complication that is intricately bound up with adverse maternal and infant outcomes. As one of the important risk factors for the development of PE, the pathogenetic mechanism of twin pregnancy in conjunction with PE is comparable to that of singleton pregnancies, which could potentially be correlated with large placenta size, augmented volume load, vascular endothelial dysfunction, oxidative stress, and immune mechanisms, etc., manifesting early disease onset yet mild disease attributes. However, the mechanism of PE in twin pregnancy remains nebulous, and its specific risk factors embrace assisted reproductive technology and chorionic sex. Clinically, twin pregnancies accompanied by PE hinge upon a solitary predictor, such as soluble fms-like tyrosine kinase-1(sFlt-1), placental growth factor (PlGF), pregnancy associated plasma protein-A (PAPP-A), or ultrasound indicators. Due to shortcomings such as insufficient sample size, the predictive performance of each indicator still needs to be tested. Further research with larger sample sizes is needed to explore the optimal predictive model for twin pregnancies with PE, in order to guide clinical decision-making.

Key words: Pre-eclampsia, Pregnancy, twin, Pathogenesis, Forecasting, Clinical decision-making

樊博扬, 胡丽燕. 双胎妊娠合并子痫前期发病机制及预测方法研究进展[J]. 国际妇产科学杂志, 2024, 51(6): 611-615.

FAN Bo-yang, HU Li-yan. Research Advancements on the Pathogenesis and Prediction Approaches of Twin Pregnancies Complicated with Preeclampsia[J]. Journal of International Obstetrics and Gynecology, 2024, 51(6): 611-615.

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