孕期血清脂溶性维生素及血脂水平与妊娠期高血压疾病关系

The relationship between the level of serum fat soluble vitamins or blood lipid of pregnant women and their occurrence of hypertensive disorder complicating pregnancy

目的:探讨妊娠期血清脂溶性维生素、血脂水平与妊娠期高血压疾病(HDP)相关性。方法:选取2016年5月-2017年5月本院收治的HDP患者102例为观察组,同期75例健康孕妇为对照组。测定两组孕妇孕早期(8~13+6周)、孕晚期(32~36周)血清脂溶性维生素A(VA)、维生素E(VE)、维生素D(VD2、VD3)含量,以及血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,记录围生儿常规指标。结果:孕早期观察组血清VA、TG、TC水平均高于对照组(P<0.05);孕晚期血清VA水平两组低于孕早期,VE、VD3、VD2及TG、TC、HDL-C、LDL-C水平高于孕早期,VA、TG、TC、LDL-C水平观察组均高于对照组,VD3、HDL-C水平低于对照组(均P<0.05);孕晚期时,正常妊娠组、妊娠期高血压组、轻度子痫前期组、重度子痫前期组血清TC、TG、LDL-C水平逐渐升高,HDL-C水平逐渐降低(均P<0.05)。观察组分娩孕龄、新生儿出生体重、胎盘重量均低于对照组(均P<0.05)。结论:孕期脂溶性维生素及脂质代谢发生变化,VD3、HDL-C相对不足及高血脂状态可能参与了HDP的发病。孕期密切监测血脂水平对早期干预及改善预后有一定意义。

Objective:To investigate the relationship between the level of serum fat soluble vitamins or blood lipid of pregnant women and their occurrence of hypertensive disorder complicating pregnancy(HDP).Methods:102 pregnant women with HDP were selected into the observation group from May 2016 to May 2017,and other 75 healthy pregnant women were selected into the control group during the same period.The levels of serum fat soluble vitamin A(VA),vitamin E(VE),vitamin D(VD2 and VD3),serum triglyceride(TG),total cholesterol(TC),highdensity lipoprotein cholesterol(HLD),and low density lipoprotein cholesterol(LDL)of all included women were measured during 8 13+6 and 32 36 gestational weeks.The indicator relevant to perinatal infants were recorded.Results:During 8 13+6 gestational weeks,the serum levels of VA,TG and TC of women in the observation group were significant higher than those of women in the control group(P<0.05).The serum level of VA of women during 32 36 gestational weeks was significant lower than that of women during 8 13+6 gestational weeks,but the serum levels of VE,VD3,VD2,TG,TC,HDL,and LDL of women were significant higher than those of women(P<0.05).During 32 36 gestational weeks,the serum levels of TC,TG,LDL of normal pregnant women in the group,women with HDP,women with mild preeclampsia or with severe preeclampsia had increased gradually,while the VD3 and HDL levels decreased gradually(P<0.05).The delivery gestational weeks,neonatal birth weight,and placental weight of women in the observation group were all significant lower than those of women in the control group(P<0.05).Conclusion:The fat soluble vitamins and lipid metabolism levels of women will change during pregnancy.The deficiency of VD3 and HDC,and occurrence of hyperlipidemia of pregnant women are all involved in the pathogenesis of HDP.The serum lipid level of women during pregnancy should be monitored closely,which can predict the development of HDP and has some significance for early intervention and prognosis of HDP.