Redline Raymond W
Case Western Reserve University and Department of Pathology, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44122, USA.
Semin Neonatol. 2004 Aug;9(4):265-74. doi: 10.1016/j.siny.2003.09.005.
Placental inflammatory disorders represent a diverse and important category of pathological processes leading to fetal and neonatal morbidity and mortality. These processes can be divided into two broad subcategories, those caused by micro-organisms and those caused by host immune responses to non-replicating antigens. The mechanisms by which these inflammatory processes cause death and disability are diverse and can be separated into four distinct classes: placental damage with loss of function, induction of premature labour and subsequent preterm birth, release of inflammatory mediators leading to fetal organ damage and transplacental infection of the fetus. Each specific inflammatory process can be modulated by properties of the specific organism, the route and timing of infection and variations in the host's genetic background and immune responsiveness. All of these factors combine to produce specific patterns of placental pathology that can be used to guide treatment, predict complications and explain adverse outcome.
胎盘炎症性疾病是导致胎儿和新生儿发病及死亡的一类多样且重要的病理过程。这些过程可大致分为两个亚类,一类由微生物引起,另一类由宿主对非复制性抗原的免疫反应引起。这些炎症过程导致死亡和残疾的机制多种多样,可分为四个不同类别:胎盘功能丧失性损伤、早产及随后的早产、炎症介质释放导致胎儿器官损伤以及胎儿经胎盘感染。每个特定的炎症过程可受特定病原体的特性、感染途径和时间以及宿主遗传背景和免疫反应性的变化所调节。所有这些因素共同作用,产生特定的胎盘病理模式,可用于指导治疗、预测并发症并解释不良结局。