妊娠期子宫螺旋动脉重塑异常与妊娠并发症的研究进展

妊娠期子宫螺旋动脉的重塑对于妊娠至关重要。子宫螺旋动脉重塑主要是血管肌层平滑肌细胞及血管壁内的内皮细胞的清除,蜕膜自然杀伤（decidua natural killer,dNK）细胞、蜕膜巨噬细胞、滋养细胞及dNK细胞与滋养细胞的相互作用是充分的螺旋动脉重塑的重要决定因素。当子宫螺旋动脉重塑发生缺陷尤其是螺旋动脉肌层部分的血管重塑缺陷,可导致各种妊娠并发症,如妊娠早期自然流产,妊娠中晚期子痫前期及胎儿生长受限等。这些不仅影响患者的身心健康,同时因诊疗成本高,亦对家庭和社会造成沉重的负担和巨大的经济损失。总结妊娠期子宫螺旋动脉重塑的过程及其关键的影响因素以及子宫螺旋动脉重塑异常与妊娠并发症发生的关系。

Research Progress of Abnormal Uterine Spiral Artery Remodeling during Pregnancy and Pregnancy Complications

Uterine spiral artery remodeling is vital for pregnancy. Uterine spiral artery remodeling is mainly the loss of smooth muscle cells in the vascular layer and endothelial cells in the vascular wall. Decidua natural killer cells (dNK), decidual macrophages, trophoblast cells and the interaction between dNK and trophoblast cells are important determinants of adequate remodeling of the spiral artery. Defects in uterine spiral artery remodeling, especially in the muscular layer of the spiral artery, can lead to a variety of pregnancy complications, such as spontaneous abortion in the first trimester, pre-eclampsia, and fetal growth restriction in the second and the third trimester. These not only affect patients′ physical and mental health, but also cause heavy burden and huge economic loss to families and society due to the high cost of diagnosis and treatment. This review summarized the process of uterine spiral artery remodeling during pregnancy and its key influencing factors as well as the relationship between abnormal uterine spiral artery remodeling and pregnancy complications.