代谢综合征相关因素对子痫前期预测价值探讨

Predictive value of factors associated with metabolic syndrome in diagnosis of preeclampsia

目的研究代谢综合征的相关因素与子痫前期的关系,建立合理的评分系统对妊娠不同阶段进行评估预测,降低子痫前期的发生和发展。方法将2012年1至6月在甘肃省妇幼保健院定期产检并分娩的单活胎妊娠孕妇221例,分为子痫前期组85例,正常妊娠对照组136例,分别在孕14~20周、分娩前1周内两个时间段空腹测定血糖、甘油三脂、高密度脂蛋白。结果 与对照组相比,子痫前期组中患者身体质量指数(t=5.211,P=0.000)增加,空腹血糖(t=4.003,P=0.000)、血清甘油三脂水平(t=2.995,P=0.001)升高、高密度脂蛋白(t=3.005,P=0.001)下降。子痫前期组和对照组中身体质量指数>31kg/m^2者分别占68.2%和26.5%,甘油三脂>3.42mmol/L分别占72.9%和32.4%,空腹血糖>5mmol/L分别占35.3%和18.4%,高密度脂蛋白<1.24mmol/L分别占37.6%和21.3%;代谢性指标评分≥2分的比例分别为65.9%和19.1%,两组比较差异均有统计学意义(均P=0.000)。结论 通过识别代谢指标紊乱可以早期识别子痫前期高危人群,对于代谢性指标评分≥2分者应给予预防建议,有望降低子痫前期的发病率。

Objective To study the relationship between preeclampsia and factors associated with metabolic syndrome （MS）, and to establish reasonable rating system to evaluate the different stage of pregnancy, so as to decrease the occurrence and development of preeclampsia. Methods Totally 221 pregnant women accepted regular prenatal check from January to June in 2012 and delivered single live birth in Gansu Provincial Maternity and Child Health Hospital. They were divided into preeclampsia group （ P group, n = 85 ） and control group（ C group, n = 136）. Fasting blood glucose, triglyceride and high density lipoprotein（HDL） were detected at the period of 14 to 20 weeks of pregnancy and at 1 week before delivery respectively. Results Compared with C group, BMI （ t = 5.211, P = 0.000） of P group increased, fasting blood glucose（ t = 4. 003, P = 0. 000） and triglyceride （ t = 2. 995, P = 0. 001 ） of P group improved, but HDL declined（t =3. 005, P =0.00）. Ratio of patients with BMI 〉 31kg/m2, triglyceride 〉 3.42mmol/L, fasting blood sugar 〉 5mmol/L and HDL 〈 1.24mmol/L in P group were higher than that in C group（68.2% and 26.5%, 72.9% and 32.4% , 35.3% and 18.4%, 37.6% and 21.3%, respectively）. Based on the rating system, proportion of patients with 2 or more points in P group was significantly higher than that in C group（65.9% and 19. 1%, respectively,）. There were significant differences between two groups（both P = 0. 000）. Conclusion People with high risk of preeclampsia can be recognized at early stage by recognizing abnormal metabolic indexes. Preventive suggestions should be given to patients with metabolic score~〉2 in order to decrease the incidence of preeclampsia.