妊娠期血脂变化情况及血脂参考范围的建立

Changes in blood lipids and establishment of blood lipid reference range during pregnancy

目的研究正常妊娠妇女血脂水平变化,建立正常妊娠期血脂水平参考范围。方法选取2018年12月—2019年12月在郑州大学第三附属医院门诊进行产检并住院分娩的正常妊娠妇女1510名,同时收集在该院体检中心体检的健康育龄期妇女200名作为对照组。妊娠妇女根据孕周不同分为孕早期(7~13+6周)、孕中期(14~27+6周)、孕晚期(28~40周),利用全自动生化分析仪检测血清甘油三酯(TG)、胆固醇(CHO)、高密度脂蛋白(HDL-c)、低密度脂蛋白(LDL-c),采用Hoffmann法建立正常妊娠不同孕周血脂参考范围。结果(1)正常妊娠时母体血清血脂水平随孕周的增加而逐渐升高,到孕晚期达高峰,其中甘油三酯(TG)在整个妊娠期升高幅度最高,TG在孕晚期较孕早期增加1.6倍,孕晚期较对照组增加3.6倍;(2)通过Hoffmann法建立本院孕妇血脂参考范围为孕早期TG(0.49~1.83)mmol/L,CHO(3.22~5.35)mmol/L,HDL-c(1.59~3.19)mmol/L LDL-c(1.09~1.97)mmol/L;孕中期:TG(0.53~2.87)mmol/L,CHO(3.38~6.90)mmol/L,HDL-c(1.60~4.25)mmol/L,LDL-c(1.22~2.32)mmol/L;孕晚期:TG(1.28~4.40)mmol/L,CHO(4.77~8.10)HDL-c(1.48~2.58)mmol/L,LDL-c(2.43~5.23)mmol/L。结论建立了本院孕期血脂参考范围,为发现血脂异常孕妇提供依据。

Objective To study the lipid changes of normal pregnancy women and establish the reference range of normal pregnancy.Methods Totally 1510 normal pregnant women who were hospitalized in the Third Affiliated Hospital of Zhengzhou University from December 2018 to December 2019,and 200 women of childbearing age in the physical examination center of our hospital were collected as the control group.Pregnational women are divided into early pregnancy(7~13+6 weeks),middle pregnancy(14~27+6 weeks),late pregnancy(28~40 weeks),using the automatic biochemical analyzer to detect serum Triglyceride(TG),Cholesterol(CHO),High density lipoprotein(HDL-c),Low density lipoprotein(LDL-c),using Hoffmann method to establish the reference range of different blood lipids during normal pregnancy.Results(1)Maternal serum blood lipid level gradually increased with the increase of weekly pregnancy during normal pregnancy,By the late pregnancy the peak,TG had the highest increase throughout pregnancy,TG increased 1.6-fold in late pregnancy compared with that of early pregnancy,late pregnancy increased 3.6 times compared with that of the control group;(2)The reference range of TG(0.49~1.83)mmol/L,CHO(3.22~5.35)mmol/L,HDL-c(1.59~3.19)mmol/L LDL-c(1.09~1.97)mmol/L;Second trimester:TG(0.53~2.87)mmol/L,CHO(3.38~6.90)mmol/L,HDL-c(1.60~4.25)mmol/L,LDL-c(1.22~2.32)mmol/L;Late pregnancy:TG(1.28~4.40)mmol/L,CHO(4.77~8.10)HDL-c(1.48~2.58)mmol/L,LDL-c(2.43~5.23)mmol/L.Conclusion The reference range of the hospital was established to provide the basis for pregnant women with dyslipidemia.