妊娠期高血压疾病与血清脂溶性维生素及血脂水平的相关性

Correlation between pregnancy-induced hypertension and serum vitamin A,E and D,blood lipid levels

目的探讨孕期血清脂溶性维生素及血脂水平的变化规律及其与妊娠期高血压疾病的关系。方法回顾性分析妊娠期高血压疾病孕妇(观察组)与同期正常妊娠孕妇(对照组)早孕期(8-12周)及晚孕期(32-36周)血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL)和低密度脂蛋白胆固醇(LDL)含量,以及血清维生素A(VA)、维生素E(VE)、维生素25(OH)D_3(VD_3)和维生素25(OH)D_2(VD_2)含量,进行对比研究。结果两组不同孕期结果比较,在早孕期,观察组VA、VE、TG和TC的水平均明显高于对照组,组间差异均具有统计学意义(P<0.05);在晚孕期,观察组VA、TG、TC和LDL的水平均高于对照组,而血清VD3、HDL水平则低于对照组,组间差异均具有统计学意义(P<0.05)。同组间晚孕期与早孕期相比,孕妇VA的水平明显降低(P<0.05),而VE、VD_3和VD_2,以及血清TG、TC、HDL和LDL水平均明显升高,除观察组的血清HDL水平外,其余各项指标的差异均具有统计学意义(P<0.05)。比较两组妊娠体质量指数(BMI)变化及分娩结局,观察组BMI明显增加,胎儿的出生月龄与出生体重则明显减少(P<0.01)。结论不同孕期血清脂溶性维生素及血脂水平均有明显变化,高血脂水平及VD3相对不足与妊娠期高血压疾病有关,监测孕期脂溶性维生素和血脂水平对于早期干预妊娠期高血压疾病及其预后具有积极的临床意义。

Objective To explore the regularity of the serum lipid-soluble vitamins and blood lipid levels during pregnancy,and its correlation with pregnancy-induced hypertension（PIH）.Methods A retrospective study was conducted to analyze and compare the level of vitamin A（VA）, vitamin E（VE）, vitamin D（VD）, triglyceride（TG）, total cholesterol（TC）, high-density lipoprotein cholesterol（HDL） and low-density lipoprotein cholesterol（LDL） in the first and third trimester between PIH group and normal control group.Results In the first trimester, the levels of VA, VE, TG, TC in PIH group were higher than those in control group（ P 〈0.05）. In the third trimester, the levels of VA, TG, TC, LDL in PIH group were higher than those in control group（ P 〈0.05）, but the levels of VD 3 and HDL were lower than those in control group（ P 〈0.05）.Compared with the first trimester, the level of VA in both groups decreased significantly in third trimester, while the levels of VE, VD 3, VD 2, TG, TC, and LDL increased（ P 〈0.05）. Compared with control group, BMI increased in PIH group, while the delivery week and neonatal birth weight decreased significantly（ P 〈0.01）.Conclusion The levels of the serum lipid-soluble vitamins and blood lipid levels change significantly during pregnancy. Hypercholesterolemia and low VD 3 status increase the risk of PIH. Thus, monitoring of blood lipids and lipid-soluble vitamins during pregnancy has important clinical significance for early intervention and prediction of pregnancy-induced hypertension.