子痫前期患者胎儿脂质变化及与母体血脂关联性的研究

The changes of fetal lipids and their association with maternal lipids in preeclampsia

目的探讨正常妊娠和子痫前期患者胎儿脂质及血脂比值变化,并分析胎儿血脂与母体血脂的关联性及可能的机制。方法选择2015年6月至2017年10月四川省人民医院产科住院的子痫前期患者203例及正常妊娠孕妇210例,分别测定孕妇和胎儿血清各项脂质指标并计算血脂比值。结果子痫前期组胎儿脐血TC、TG、LDL-C、apo B100、AI和血脂比值TG/HDL-C、TC/HDL-C、LDL-C/HDL-C及log(TG/HDL-C)均显著性高于正常妊娠组。分析脐血和母体血脂谱的相关性,结果表明脐血TC与母体apo A1负相关,与母体log(TG/HDL-C)正相关;脐血apo A1与母体apo A1正相关,与母体apo B100、LDLC/HDL-C负相关;脐血apo B100与母体TC、apo A1、HDL-C负相关;脐血HDL-C与母体TG、TG/HDL-C和log(TG/HDL-C)正相关;脐血LDL-C与母体TG/HDL-C和log(TG/HDL-C)正相关,与母体apo A1和HDL-C负相关;脐血TG/HDL-C与母体log(TG/HDL-C)负相关;脐血log(TG/HDL-C)与母体TG、TG/HDL-C和log(TG/HDL-C)负相关。结论胎儿血脂与母体血脂存在弱相关,子痫前期组胎儿TG、TC水平显著高于正常妊娠组胎儿,可能是因为子痫前期组胎儿生长受限,对TG、TC利用减少,造成胎儿血液循环TG、TC堆积。

Objective To compare the changes of fetal lipids and lipids ratio between normal pregnancy and preeclampsia padents,and analyze the relationship between fetal lipids and maternal lipids and the possible mechanism.Methods We selected 210 normal pregnant women and 203 pregnant women with preeclampsia from our department between June 2015 and October 2017.Maternal and fetal lipids were determined and lipid ratio was calculated.Results The levels of TC,T G,LDL-C,apo-B100,AI and blood lipid ratios such as TG/HDL-C,TC/HDL-C,LDL-C/HDL-C and log(TG/HDL-C)of fetal cord blood in the preeclampsia group were significantly higher than those of the normal pregnancy group.Controlling the impact of preeclampsia on maternal and fetal plasma lipid levels,partial correlation analysis were used to evaluate the correlation between umbilical cord blood and maternal blood lipids.The results showed that umbilical cord blood TC were negative correlated with maternal apo-A1,and positive correlated with maternal log(T G/HDL-C);umbilical cord blood apo-A1 was positively correlated with maternal apo-Al,and negative correlation with maternal apo-B1OO,LDL-C/HDL-C;umbilical cord blood apo-BlOO was negatively correlated with maternal TC,apo-A1,HDL-C;umbilical cord blood HDLC was positively correlated with maternal TG,TG/HDL-C and log(TG/HDL-C);umbilical cord blood LDL-C was positively correlated with maternal TG/HDL-C and log(TG/HDL-C),and negatively correlated with maternal apo-A1 and HDL-C;umbilical cord blood T G/HDL-C was negatively correlated with maternal log(TG/HDL-C),and umbilical cord blood log(T/HDL-C)were negatively correlated with maternal TG,TG/HDL-C and log(TG/HDL-C).Conclusion Fetal and maternal blood lipids axe correlated weakly.Levels of cord blood TG,TC in preeclampsia were significantly higher than those of normal pregnancy group.The reasons mainly might be due to fetal growth restriction and a reduction of utilization of TG and TC in preeclampsia,which may cause the accumulation of TG and TC in fetal blood circulation.