妊娠期糖尿病与妊娠期高血压疾病病理机制的相关性

妊娠期糖尿病(GDM)为妊娠期特有疾病,易造成孕产妇难产、产褥期感染、酮症酸中毒,胎儿窘迫、胎儿畸形甚至胎死宫内等不良妊娠结局。妊娠期高血压疾病(HDP)包括妊娠期高血压、子痫前期(preeclampsia)、子痫,以及慢性高血压并发子痫前期和妊娠合并慢性高血压,临床表现为高血压、蛋白尿及水肿,严重影响孕妇体内各脏器功能,是孕产妇及围生儿死亡的主要原因。HDP中子痫前期,尤其是重度子痫前期,是造成新生儿不良妊娠结局的重要原因,通常需要及时剖宫产终止妊娠。近年国内外许多研究已经证实GDM和HDP在内皮功能紊乱、血脂异常、炎症因子、肾素-血管紧张素-醛固酮系统(RAAS)等多方面有相关性。现就两种疾病在上述相关性方面进行综述。

Correlation of Pathological Mechanism between Gestational Diabetes Mellitus and Hypertensive Disorders of Pregnancy

Gestational diabetes mellitus(GDM), a particular disease of pregnancy, easily causes a series of adverse pregnancy outcomes, such as parodynia, puerperal infection, ketoacidosis, fetal distress, fetal abnormalities,even dead fetus in uterus. Hypertensive disorders of pregnancy(HDP), including gestational hypertension,preeclampsia(PE), eclampsia, chornic hypertension with superimposed preeclampsia, and pregnancy combined with chornic hypertension, are also main causes of maternal death and perinatal death. The clinical manifestation of HDP is characterized by hypertention, proteinuria and edema following functional lesion of organs. It is necessary for those HDP patients with PE(especially, severe PE) to terminate the pregnancy, in which the adverse outcomes of newborns are introduced. In recent years, many studies showed the correlation between GDM and HDP in the pathological mechanism, such as endothelial dysfunction, dyslipidemia, inflammatory factors, renin-angiotensin-aldosterone system(RAAS) and others. In this article, we reviewed the correlation of pathological mechanism between GDM and HDP.