国际妇产科学杂志

国际妇产科学杂志 ›› 2012, Vol. 39 ›› Issue (6): 539-541.

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早期妊娠子痫前期的预测和预防

林其德   

  1. 200001上海交通大学医学院附属仁济医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-12-15 发布日期:2012-12-15

Early Pregnancy Prediction and Prevention of Preeclampsia

LIN Qi-de   

  1. Shanghai Renji Hospital of Shanghai Jiao Tong University School of Medicine， Shanghai 200001，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2012-12-15 Online:2012-12-15

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摘要： 子痫前期是胎母围生期发病和死亡的重要原因，其有效预测和预防就显得特别重要。预测子痫前期的检查方法有多种，包括高危因素的临床分析（病史和体检）、实验室和血液动力学检查。其中，有前景的检测如下：危险因素包括年龄、孕产次、前次妊娠子痫前期病史、子痫前期家族史、多胎妊娠和已有内科合并症，如糖尿病、高血压和肾病，易栓症和自身免疫性疾病。早期妊娠预测子痫前期的实验室检查具有特异度比敏感度高的特点，如体质量指数（BMI）＞34 kg/m2；平均动脉压（MAP）90 mmHg（1 mmHg=0.133 kPa）；子宫动脉多普勒（双切迹）和血管生成因子［胎盘生长因子（PIGF），血管内皮生长因子（VEGF），可溶性血管内皮生长因子受体1（sFlt-1）］，特别是sFlt-1/PIGF比值。虽然预防性治疗子痫前期有许多方案，但是只有低剂量阿司匹林和钙片有良好的效果。因此，应继续深入对子痫前期发病机制的研究，以发现新的生物指标和设计新的更好的预测手段。而更好的预测方案的出现有助于发展新的治疗方案。

关键词: 子痫前期, 预测, 预防, 早期妊娠

Abstract: Preeclampsia is considered leading cause of feto-maternal perinatal morbidity and mortality. It is very important to develop effective prediction and prevention of preeclampsia. Varied tests used to predict preeclampsia include clinical identification of high risk（medical history and examination），laboratory and hamodynamic tests. Among them，the promising tests are as following：risk factors include age；parity；history of preeclampsia in a previous pregnancy；family history of preeclampsia，multiple pregnancy and pre-existing medical conditions such as diabetes，chronic hypertention，renal disease；thrombophilia and autoimmune disease.The tests in early pregnancy for predicting of preeclampsia have better specificity than sensitivity，such as BMI＞34 kg/m2；MAP of 90 mmHg（1 mmHg=0.133 kPa）；uterine artery Doppler（bilateral notching） and angiogenic factors（PIGF，VEGF，sFlt-1），especially sFlt-1/PIGF. Although there are various treatment options for preventing preeclampsia， the beneficial effect were observed only in low aspirin and calcium.The need for continuing research to pathogenesis of preeclampsia that will find new biomarkers and design the promise predictive models. Better prediction will allow us to target existing prevention，such as it is，and to also develop new treatment in future.

Key words: Pre-eclampsia, Prediction, Prevention, Early pregnancy