妊娠期高血压疾病胎儿血脂代谢异常研究

Research of metabolic abnormalities of fetal lipid profile in patients with pregnancy induced hypertension

目的通过测定妊娠期高血压疾病患者静脉血及新生儿血脂水平,评估妊娠期高血压疾病患者胎儿血脂异常状态。方法选择2014年1月至2014年12月妊娠期高血压疾病患者30例作为观察组,孕期血压水平正常孕妇60例作为对照组。搜集孕妇年龄、产次、孕周、产前体重、孕前体重及合并妊娠期糖尿病情况。在孕妇分娩当天,检测孕妇空腹甘油三酯、胆固醇、高密度脂蛋白和低密度脂蛋白水平;并检测新生儿脐血甘油三酯、胆固醇、高密度脂蛋白和低密度脂蛋白水平。比较两组脐血中血脂水平的差异及其与孕妇血脂水平的相关性。结果妊娠期高血压疾病孕妇甘油三酯和胆固醇水平均高于正常妊娠组[甘油三酯:(4.029±2.25)mmol/L vs(2.35±0.87)mmol/L,P=0.001;胆固醇:(6.06±1.89)mmol/L vs(5.19±1.01)mmol/L,P=0.036],差异有统计学意义。妊娠期高血压病新生儿脐血甘油三酯水平高于正常妊娠组[(0.432±0.23)mmol/L vs(0.259±0.17)mmol/L,P=0.005],高密度脂蛋白水平低于正常妊娠组[(0.650±0.15)mmol/L vs(0.768±0.23)mmol/L,P=0.035],差异有统计学意义。结论妊娠期高血压疾病孕妇和新生儿均存在血脂代谢异常,在孕妇表现为高甘油三酯和高胆固醇,而在新生儿表现为高甘油三酯和低的高密度脂蛋白水平。

Objective To examining the level of blood lipids in patients with pregnancy induced hypertension（ PIH） and the level of blood lipid in neonates with umbilical cord blood,to evaluate the abnormal status of fetal dyslipidemia in the patients with PIH. Methods Totally 30 PIH and 60 normal pregnant women who chosed from January 2014 to October 2014 were recruited in the present study. Maternal age,parity,gestational age,pre-gravid and prepartum weight and complication with gestational diabetes mellitus were collected for analysis. Triglyceride,cholesterol,high density lipoprotein and low density lipoprotein were examined in both maternal venous and umbilical cord venous plasma at the day of delivery. Lipid profile between groups were compared,and the relationship between maternal and fetal lipid were analyzed. Results Triglyceride and cholesterol were both higher in pregnant women with PIH（ Triglyceride 4. 029 ± 2. 25 vs 2. 35 ± 0. 87,P = 0. 001; cholesterol 6. 06 ± 1. 89 vs 5. 19 ± 1. 01,P = 0. 036）,the difference was statistically significant. In umbilical cord venous blood,triglyceride was higher（ 0. 432 ± 0. 23 vs 0. 259 ± 0. 17,P = 0. 005）,and high density lipoprotein was lower（ 0. 650 ± 0. 15 vs 0. 768 ± 0. 23,P = 0. 035） in PIH group,the difference was statistically significant. Conclusion To sum up,dyslipidemia exists in both mother and neonatal in PIH pregnancy. In PIH mother,triglyceride and cholesterol were both higher; in umbilical cord blood,triglyceride was higher and high density lipoprotein was lower.