妊娠中晚期血脂及载脂蛋白水平的观察研究

Observation on the Level of Blood Lipids and Apolipoprotein in the Middle and Late Pregnancy

目的通过观察妊娠中晚期血脂及载脂蛋白水平,初步了解妊娠期脂代谢特点,为防治妊娠期脂代谢紊乱提供依据。方法回顾性队列研究,纳入2014年10月至2016年2月在我院产科就诊的孕妇280例,收集其各孕期总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白a[Lp(a)]水平。结果研究对象年龄(29.6±4.9)岁(19~46岁)。在中孕期(T2期)、晚孕期(T3期)TC分别为(4.86±1.15)mmol/L、(6.55±1.65)mmol/L;LDL-C分别为(2.48±0.85)mmol/L、(3.63±1.06)mmol/L;HDL-C分别为(1.88±0.51)mmol/L、(1.73±0.58)mmol/L;ApoA1分别为(1.85±0.56)g/L、(2.18±0.52)g/L;TG的中位数(25th,75th)分别为1.58mmol/L(1.15,2.16)、3.90mmol/L(2.88,5.25);ApoB的中位数(25th,75th)分别为1.10g/L(0.84,1.32)、1.23g/L(25%th1.03,75%th1.46);Lp(a)的中位数(25th,75th)分别为235mg/L(144,644)、129mg/L(66,251)。TC、TG、LDL-C、ApoA1、ApoB水平均随孕周增加而增加,差异均有统计学意义(P<0.05);HDL-C和Lp(a)水平在T3期较T2期则有所下降,差异均有统计学意义(P<0.05)。结论中晚孕期孕妇部分血脂指标明显改变,脂代谢紊乱发生率升高。

Objective To observe the level of lipid metabolism and apolipoprotein in the middle and late pregnancy,and to provide a basis for the prevention and treatment of lipid metabolism disorder during pregnancy. Methods The total 280 pregnant women,admitted to obstetrics in our hospital from October 2014 to February 2016,were included in the retrospective cohort study,and collect their total cholesterol(TC),triglycerides(TG),LDL cholesterol(LDL-C),HDL cholesterol(HDL-C),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB)and Lipoprotein a[Lp(a)] levels. Results The subjects were aged at(29.6±4.9)years old(19~46).In the middle pregnancy(T2 period)and late pregnancy(T3 period),the TC level were(4.86±1.15)mmol/L and(6.55±1.65)mmol/L,LDL-C were(2.48±0.85)mmol/L and(3.63±1.06)mmol/L respectively,HDL-C were(1.88±0.51)mmol/L and(1.73±0.58)mmol/L respectively,and ApoA1 were(1.85±0.56)g/L and(2.18±0.52)g/L respectively.The median number of TG(25 th ,75 th )was 1.58mmol/L(1.15,2.16)and 3.90mmol/L(2.88,5.25),respectively.The median number of ApoB(25 th ,75 th )was 1.10 g/L(0.84,1.32)and 1.23g/L(25% th 1.03,75% th 1.46),respectively.The median(25 th ,75 th )of Lp(a)was 235mg/L(144,644)and 129mg/L(66,251),respectively.The average levels of TC,TG,LDL-C,ApoA1 and ApoB increased with gestational week,statistically significant( P <0.05).The levels of HDL-C and Lp(a)decreased in the T3 period compared with the T2 period,statistically significant( P <0.05). Conclusion The blood lipid indexes in pregnant women in late pregnancy were significantly changed,and the incidence of lipid metabolism disorder increased.