生长受限胎儿孕中晚期脐血脂类水平的研究

Second-trimester Lipoproteins Level in Fetal Growth Restriction

目的脐血中脂类水平差异与妊娠结局的关系。方法(1)对25例FGR患者及35例对照(对照产前诊断组)在产前经皮穿刺抽取脐血,进行脐血脂类水平检测,观察两组间这些指标的差异。(2)收集同期分娩的25例SGA(小于胎龄儿)、25例AGA(适于胎龄儿)及22例LGA(大于胎龄儿)出生时脐血,测定脐血中脂类水平差异。结果(1)两组孕中晚期脐血脂类检测只有TC、LDL-C的水平与对照组有显著性差异(均P<0.001),其余各值无显著性差异。(2)SGA组各项脂类水平分别与AGA、LGA组比较,均无显著性差异(P>0.05)。3、正常体重儿孕中晚期与分娩期血脂水平比较,分娩期脐血中的TG、TC等各项指标均明显增高(均P<0.001),但LDL增高不明显(P=0.096)。结论(1)FGR组孕中期已出现脂类代谢紊乱。(2)正常体重儿分娩期较孕中晚期脐血脂类大部分指标水平均增加,说明胎儿的脂肪堆积可能在孕晚期。

Objective To analyse the relations between the concentrations of umbilical cord lipoproteins and fetal growth restriction （FGR）. Methods 25 cases of FGR, 35 cases of control were studied, blood samples were collected from umbilical cord blood ,TG,TC, HDL,LDL were determined;TG,TC,HDL,LDL ect were determined, in 25 cases of SGA,25 cases of AGA and 22 cases of LGA. Results TC level in FGR group was higher than control（ 1.51 ±0.37 mmol/L vsl. 04 ±0.33 mmol/L） ,LDL -C level in FGR group was lower than control （P 〈 0. 001 ）. lipoproteins levels were no significant change among three newborn groups. 3. The majority of Umbilical lipoproteins levels were higher in delivery than in midtrimser,but LDL show no significant change （0.71±0.20 mmol/L vs 0.63 ± 0.22 mmol/ L, P -0.096）. Conclusions lipoprotein disorder of FGR occurred in midtrimser instead of delivery time. Higher levels of umbilical lipoprotein concentrations also found in the third trimser in normal pregnancy, which may account of accelerate of lip in fetal.