重度子痫前期对早产新生儿脂蛋白代谢和免疫功能的影响

Impact of severe preeclampsia on lipid metabolism and immune function in premature newborn

重度子痫前期是否对早产新生儿脂蛋白代谢和免疫功能产生影响尚未明确。本研究选取2011年12月至2014年12月间我院妇产科诊治的106例重度子痫前期患者活产早产儿为研究对象,另随机选取同期孕周匹配的106例无子痫前期的自发性活产早产儿作为对照组,分别测定和比较两组早产儿脂蛋白代谢指标:甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo-B)及免疫功能指标:T细胞亚群、NK细胞、IgG、IgM和IgA含量的变化。结果显示,与对照组相比,子痫前期组新生早产儿的身长、出生体重和胎盘质量显著降低,小于胎龄儿的比例则明显增加(P<0.05),而两组间在Apgar评分、胎龄、使用肺表面活性物质和呼吸支持的比例比较未见显著差别(P>0.05);子痫前期组的脂蛋白代谢指标TC、TG、Apo-A1也均出现明显降低(P<0.05),LDL-C、HDL-C和Apo-B两组间比较则无显著性改变(P>0.05);而且,子痫前期组早产新生儿的CD4^+、CD8^+、CD19^+、NK细胞和IgG的水平也明显低于对照组(P<0.05),但CD3^+、IgM和IgA的含量两组间比较则无显著差别(P>0.05)。据此,本研究结果表明,重度子痫可引起早产儿的脂蛋白代谢及免疫功能紊乱,进而导致胎儿发育障碍。

The effects of severe preeclampsia on lipid metabolism and immune function in premature newborn are still unclear. In this study, 106 cases of live-birth preterm infants delivered by women with early-onset severe preeclampsia from February 2007 to December 2014 in our hospital were enrolled and additional 106 spontaneous early preterm live-birth infants delivered during the same period were randomly selected as controls. This study covered lipoprotein metabolism indicators which con- tained triglyceride （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C）, apolipoprotein A1 （Apo-A1）, apolipoprotein B （Apo-B） and immune function indicators that included counts of T cell subsets, NK cells, and concentrations of IgG, IgM and IgA. The results showed that, compared with the con trol group, birth height , body weight and placenta weight were significantly decreased, and the proportion of infant inadequate was significantly increased （P〈0.05）. However, there were no significant differences between the 2 groups in Apgar score, birth age, proportion of the infant who needed pulmonary surfactant and respiratory support （P〉0.05）. TC, TG, Apo-A1 in the preeclampsia group were significantly reduced （P〈0.05）, while no significant differences were observed inlevels of LDL- C, HDL-C and Apo-B between the two groups （P〉0.05） ; Moreover, proportions of CD4＋ , CD8＋ , CD19＋ T cells and NK cells as well as level of IgG in the preeclampsia preterm infants were significantly decreased than those of the control group （P 〈0.05）, but there were no significant differences between the two groups in proportion of CD3＋ cells , levels of IgM and IgA （P〉0.05）. Altogether, our study indicates that severe preeclampsia can cause disturbance of lipoprotein metabolism and im- mune function in the premature infants thus leads to developmental disorders.