胎盘蛋白13在子痫前期中的研究进展

Research Progress of Placental Protein 13 in Preeclampsia

摘要: 子痫前期是妊娠期所专有的疾病，它是在妊娠20周后发生，主要是以妊娠期始发出现的以血压升高和尿中出现蛋白为主要临床表现的妊娠相关疾病。在所有妊娠中大约有2%~5%的子痫前期孕产妇，并且使3%~5%的妊娠复杂化。它严重危及孕产妇和胎儿的健康，目前仍是导致全球孕产妇和新生儿发病率、死亡率的重要因素。如果该病没有得到及时干涉、治疗，最终将会导致子痫、流产、早产、胎盘早剥、HELLP综合征(溶血、肝酶升高、血小板减少)等并发症，少数妊娠还将出现胎儿生长受限(FGR)，甚至出现胎死宫内等更严重的不良妊娠结局。但是目前尚未发现可以有效、准确、经济地预测子痫前期的生物学标志物，发病原因和机制也尚未完全阐明。当前很多研究学者认为子痫前期主要是以子宫胎盘受损所致功能不良的多个原因、多种发病病理生理及多条发病途径的疾病。胎盘蛋白13 (PP13)作为高效调节子宫胎盘表达的特异性蛋白之一，被发现在子宫胎盘的滋养细胞中可以高度表达，故考虑PP13可能是对子痫前期的早期预防和早期治疗的预测生化指标，在疾病预测和机制探索研究中可能发挥作用。根据目前国内外PP13的最新的研究进展，针对PP13在子痫前期中的应用，本综述探讨作为研究领域中有潜在价值的预测标志物在子痫前期中的应用及发展。

Abstract: Preeclampsia is a pregnancy-specific disease, which occurs after 20 weeks of gestation and is mainly a pregnancy-related disease with elevated blood pressure and protein in urine as the main clinical manifestations. Preeclampsia affects about 2% to 5% of all pregnancies and complicates 3% to 5% of pregnancies. It seriously endangers maternal and fetal health and remains an important con-tributor to maternal and neonatal morbidity and mortality worldwide. If the disease is not timely interfered and treated, it will eventually lead to complications such as eclampsia, abortion, prema-ture delivery, placental abruption, HELLP syndrome (hemolysis, elevated liver enzymes, thrombo-cytopenia), and fetal growth restriction (FGR) or even intrauterine death in a few pregnancies. However, no biomarkers that can effectively, accurately and economically predict preeclampsia have been found, and the pathogenesis and mechanism of preeclampsia have not been fully eluci-dated. At present, many researchers believe that preeclampsia is mainly a disease with multiple causes, pathophysiology and multiple pathways of dysfunction caused by uterine and placenta damage. Placental protein 13 (PP13), one of the specific proteins that efficiently regulate uter-ine-placental expression, was found to be highly expressed in trophoblast cells of the uterine pla-centa. Therefore, PP13 may be a predictive biochemical marker for the early prevention and treat-ment of preeclampsia, and may play a role in the study of disease prediction and mechanism explo-ration. Based on the latest research progress of PP13 at home and abroad, this review discusses the application and development of PP13 in preeclampsia as a potential predictive marker in the re-search field.