膳食因素与妊娠期高血压疾病关系的病例对照研究

Dietary Factors and Hypertensive Disorder Complicating Pregnancy:A Case-control Study

目的探讨妊娠期膳食因素在妊娠期高血压疾病（HDCP）发生中的作用,为制定有效的膳食营养干预措施提供科学依据。方法选择2010年5月—2012年5月甘肃省妇幼保健院产科病房诊断为HDCP的妊娠妇女204例为研究组,另选择同期本院收治的正常妊娠妇女204例作为对照组。采用食物频率法进行膳食调查,询问调查对象妊娠期食物摄入种类及频率,包括粮谷类、肉禽鱼类、蛋类、奶类、豆类、蔬菜水果类、干果类和咸菜泡菜类。将各类食物摄入频率分为5个等级：每日吃（≥7次/周）、每周吃3~6次、每周吃1~2次、每月吃2~3次、几乎不吃（≤1次/月）,依次评为4、3、2、1、0分。采用单因素及多因素Logistic回归分析影响HDCP发生的膳食因素。结果两组粮谷类和蔬菜水果类评分比较,差异均无统计学意义（P〉0.05）;研究组肉禽鱼类、蛋类、奶类、豆类、干果类评分均低于对照组,咸菜泡菜类评分高于对照组（P〈0.05）。以是否患有HDCP为因变量,以粮谷类、肉禽鱼类、蛋类、奶类、豆类、蔬菜水果类、干果类和咸菜泡菜类分别作为自变量进行单因素Logistic回归分析,结果显示,摄入肉禽鱼类、蛋类、奶类、豆类、干果类、咸菜泡菜类是HDCP发生的影响因素（P〈0.05）,其中危险因素为咸菜泡菜类,保护因素为肉禽鱼类、蛋类、奶类、豆类、干果类。以是否患有HDCP为因变量,以单因素分析中有统计学意义的变量为自变量,进行多因素Logistic回归分析,结果显示,咸菜泡菜类、蛋类、奶类是HDCP发生的影响因素（P〈0.05）,其中咸菜泡菜类为危险因素,蛋类、奶类为保护因素。结论妊娠期摄入咸菜泡菜类食品会增加妊娠妇女发生HDCP的风险,而多食蛋类、奶类可有效预防或减少HDCP的发生。

Objective To explore the role of dietary factors in development of hypertensive disorders complicating pregnancy（HDCP）,to provide a scientific basis for effective dietary nutritional interventions.Methods From May 2010 to May 2012,in Gansu Provincial Maternity and Child Care Hospital,204 pregnant women with HDCP were enrolled as study group,204 normal pregnant women as control group.This study used food frequency method to perform the investigation,inquiring the kinds and frequency of their food intake,including cereals,meat/poultry/fish,eggs,milk,beans,fruits/vegetables,nuts,pickles.The frequencies of food were divided into levels A（everyday intake,≥7 times/week,scored 4）,B（weekly intake,3-6 times/week,scored 3）,C（weekly intake,1-2 times/week,scored 2）,D（monthly intake,2-3 times/month,scored 1）,E（intake seldom or never,≤ 1 time/month,scored 0）.This study used univariate and multivariate Logistic regression analysis to analyze the dietary factors influencing HDCP development.Results There was no significant difference in scores of cereals,fruits/vegetables between 2 groups（P 0.05）.The scores of meat/poultry/fish,eggs,milk,beans,nuts were lower,those of pickles higher in study group than in control group（P 0.05）.Taking HDCP suffering as dependent variable,and cereals,meat/poultry/fish,eggs,milk,beans,fruits/vegetables,nuts,pickles as independent variables,the univariate Logistic regression analysis showed that intakes of meat/poultry/fish,eggs,milk,beans,nuts,pickles were related to HDCP（P 0.05）,thereinto the risk factor was pickles,the protective factors were cereals,meat/poultry/fish,eggs,milk,beans,nuts.Taking HDCP suffering as dependent variable and the significant independent variables in univariate analysis as independent variables,Logistic regression analysis showed that pickles,eggs and milk were related to HDCP（P 0.05）,thereinto pickles was risk factor,eggs and milk were protective factors.Conclusion Intake of pickles would increase the risk of HDCP,while intake of eggs and milk prevent or reduce HDCP incidence effectively.