外周血炎症指标、血小板参数、凝血指标与子痫前期的关系研究进展
Research Progress on the Relationship between Peripheral Blood Inflammatory Indicators, Platelet Parameters, Coagulation Indicators and Preeclampsia

子痫前期(Preeclampsia, PE)属于妊娠期高血压疾病，是一种妊娠期特有的、多因素、多机制、多通路致病的疾病，与子痫、HELLP综合征、胎盘早剥、早产、胎儿宫内生长受限、小于胎龄儿和宫内死亡等母婴不良结局密切相关，因此其诊疗已然成为妇产科医师及科研工作者亟待解决的问题。既往有学者提出子痫前期发病机制的两阶段学说。第一阶段为临床前期，患者无特殊表现，但由于子宫螺旋动脉滋养细胞重铸障碍，导致胎盘缺血、缺氧，进而释放胎盘因子；第二阶段胎盘因子进入母体血液循环，激活炎症级联反应，进而损伤血管内皮，出现胎盘氧化应激、高血压和蛋白尿的特征性表现，引起子痫前期–子痫。近年研究表明其与免疫炎症反应异常、氧化应激、代谢异常密切相关，以上机制可通过引起全身炎症反应促进病情的进展。有研究显示子痫前期与妊娠期血流异常高凝状态及子宫动脉血流频谱异常相关，因此寻找与子痫前期严重程度密切相关的指标用于评估患者的病情进而实现及时有效干预、治疗子痫前期，可达到改善母婴不良结局的目的。基于此，本文旨在通过炎症反应与子痫前期的相关性，通过多个参数的比较，寻找简便、经济的检测方法及时地发现子痫前期、适时干预和治疗以改善孕产妇不良结局，为子痫前期的早期诊疗拓展新思路，寻求新的研究方向。本文将基于多年来的相关研究文献，主要以子痫前期有关的炎症反应机制以及与炎症反应密切相关的血管内皮损伤机制的相关的研究进行综述，旨在寻找合适的外周血参数评估患者病情并为终止妊娠的时机提供有力的理论依据。
Preeclampsia (PE) is a gestational hypertension disease, which is a specific, multi-factor, mul-ti-mechanism and multi-pathway disease in pregnancy. It is closely related to maternal and infant adverse outcomes such as eclampsia, HELLP syndrome, placental abruption, preterm birth, fetal in-trauterine growth restriction, small for gestational age and intrauterine death. Therefore, its diag-nosis and treatment has become an urgent problem for obstetricians and researchers. Previous scholars have proposed a two-stage theory of the pathogenesis of preeclampsia. The first stage is the preclinical stage, in which the patient has no special manifestations, but due to the failure of troph-oblast remodeling in the spiral artery of the uterus, the placenta is ischemia and hypoxia, and then releases placental factors. In the second stage, placental factors enter the maternal circulation and activate the inflammatory cascade, which in turn damages the vascular endothelium and causes the characteristic manifestations of placental oxidative stress, hypertension and proteinuria, leading to preeclampsia-eclampsia. Recent studies have shown that it is closely related to abnormal immune inflammatory response, oxidative stress, and metabolic abnormalities. The above mechanisms can promote the progress of the disease by causing systemic inflammatory response. Studies have shown that preeclampsia is related to abnormal hypercoagulable state of blood flow and abnormal uterine artery blood flow spectrum during pregnancy. Therefore, finding indicators closely related to the severity of preeclampsia can be used to evaluate the patient's condition and achieve timely and effective intervention and treatment of preeclampsia, which can achieve the purpose of im-proving the adverse outcomes of mothers and infants. Based on this, this paper aims to find a sim-ple and economic detection method to detect preeclampsia in time through the correlation between