国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (6): 638-642.doi: 10.12280/gjfckx.20250708

• 产科生理及产科疾病:综述 • 上一篇    下一篇

血清尿酸水平与子痫前期相关性研究进展

陈阳, 张国英   

  1. 210036 南京医科大学第一附属医院产科
  • 收稿日期:2025-06-26 出版日期:2025-12-15 发布日期:2025-12-30

Research Progress on the Correlation between Serum Uric Acid Level and Preeclampsia

CHEN Yang, ZHANG Guo-ying   

  1. Department of Obstetrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210036, China
  • Received:2025-06-26 Published:2025-12-15 Online:2025-12-30

摘要:

子痫前期(preeclampsia,PE)是妊娠期特有的多系统疾病,以妊娠20周后新发高血压伴蛋白尿或终末器官功能障碍为主要特征。PE发病机制复杂,涉及血管内皮功能障碍、氧化应激失衡等多种因素。近年来,血清尿酸水平升高作为氧化应激的生物标志物,与PE的严重程度和不良妊娠结局的相关性逐渐受到关注。研究表明,PE患者血清尿酸水平显著升高,其机制可能与胎盘缺血缺氧、肾血流动力学改变及肾小管尿酸转运蛋白表达上调有关。尿酸通过引发氧化应激、抑制血管内皮细胞功能、激活炎症反应等途径参与PE的病理进展,并与其他PE标志物存在协同效应。尽管血清尿酸水平与PE的严重程度及不良妊娠结局密切相关,且妊娠早期血清尿酸水平升高可预测PE的发生风险,但尿酸作为独立诊断标志物的特异度有限,其升高也可能与其他炎症标志物存在协同作用。未来研究应聚焦于进一步优化尿酸作为生物标志物的检测方法、临界值共识及联合预测模型的开发,明确尿酸在PE病理机制中的具体作用,为早期干预提供更有力的理论依据。

关键词: 子痫前期, 尿酸, 氧化性应激, 生物标记, 内皮功能障碍, 预测模型

Abstract:

Preeclampsia (PE) is a pregnancy-specific multisystem disease, mainly characterized by newly-onset hypertension accompanied by proteinuria or end-organ dysfunction after 20 weeks of gestation. The pathogenesis of PE is complex, involving multiple factors such as vascular endothelial dysfunction and oxidative stress imbalance. In recent years, the elevation of serum uric acid level, as a biomarker of oxidative stress, has gradually attracted attention for its correlation with the severity of PE and adverse pregnancy outcomes. Studies have shown that serum uric acid level in patients with PE is significantly increased. The mechanism may be related to placental ischemia-hypoxia, changes in renal hemodynamics, and upregulation of the expression of uric acid transporters in renal tubules. Uric acid participates in the pathological progression of PE through pathways such as triggering oxidative stress, inhibiting the function of vascular endothelial cells, and activating the inflammatory response, and has a synergistic effect with other PE biomarkers. Although the serum uric acid level is closely related to the severity of PE and adverse pregnancy outcomes, and an elevated serum uric acid level in the early stage of pregnancy can predict the risk of PE, the specificity of uric acid as an independent diagnostic marker is limited, and its elevation may also have a synergistic effect with other inflammatory markers. Future research should focus on further optimizing the detection method of uric acid as a biomarker, reaching a consensus on the critical value, and developing a combined prediction model, clarifying the specific role of uric acid in the pathological mechanism of PE, so as to provide a more powerful theoretical basis for early intervention.

Key words: Pre-eclampsia, Uric acid, Oxidative stress, Biomarkers, Endothelial dysfunction, Predictive model