子痫前期与血肉碱关系的研究

The relationship between pre-eclampsia in patients and blood levels of carnitine and lipid metabolism

目的探讨孕妇血浆中肉碱水平与子痫前期的关系,及该疾病血脂代谢的改变。方法①利用串联质谱检测337例健康妊娠孕妇及84例子痫前期孕妇的血干滤纸片,测定血清总肉碱、游离肉碱、中长链肉碱、短链肉碱。②常规测定血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(apoA)-1及载脂蛋白B(apoB)。结果①子痫前期病例组中除中链脂酰肉碱外,其他所有肉碱血浆浓度均明显高于对照组(团体t检验),以孕32周后更为显著(P<0.01)。游离肉碱和短链、长链脂酰肉碱的检测值和对照组相比约增加50%(P<0.01)。②子痫前期病例组中血TC,TG,LDL,apoB较对照组显著升高(P<0.01),HDL,apoA-1较对照组显著降低(P<0.01)。结论①子痫前期疾病的发生、发展,可能与肉碱水平有关,随孕龄增加更为显著,故检测肉碱浓度可有助子痫前期的病情评估。②子痫前期病程中可能存在血脂代谢异常。

Objective To investigate the relationship between the maternal plasma carnitine levels and pregnancy-induced pre-eclampsia, and the changes in lipid metabolism in pregnancy-induced hypertension. Method ① Using tandem mass spectrometry to detect blood serum total carnitine, free carnitine, medium-and long-chain carnitine, short-chain carnitine through filter paper in 337 cases of normal pregnant women and 84 examples of pre-eclampsia in pregnant women. ②TC, TG, HDL-C, LDL-C, apoA-1 and apoB were examined, and to calculate the ratio of LDL-C/HDL-C and apoA1/apoB. Results ①Pregnancy-induced hypertension group, in addition to medium-chain acyl-carnitine, all other plasma carnitine concentrations were significantly higher than those in control group （group t test） especially 32 weeks after pregnancy （P〈0.01）. Compared with the control group free carnitine anct short chain, long-chain acyl-carnitine detection value increased approximately 50% （P〈0.01）. ② Compared with the control group, blood TC, TG, LDL-C and apoB in pregnancy-induced hypertension increased significantly（P〈0.01）, HDL-C, apoA1 decreased significantly （P〈0.01）. Conclusion ①The occurrence of pregnancy-induced hypertension and development may be related to the level of carnitine, more significantly with the gestational age increase. To detect carnitine concentration can be helpful to condition assessment. ②Abnormal lipid metabolism may exist in the course of pregnancy-induced hypertension.