妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白表达特征及预测妊娠结局价值

The expression features of serum high-density lipoprotein of pregnant women with gestational diabetes mellitus and pregnancy-induced hypertension syndrome and its predictive value for pregnancy outcomes

目的:探索妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白表达特征以及对妊娠结局的预测意义。方法:选取2014—2016年本院确诊的妊娠期糖尿病合并妊娠高血压综合征孕妇95例为观察组,产前检查健康孕妇100例为对照组,测定空腹血糖和口服葡萄糖试验,高密度脂蛋白水平,测量血压,对观察组血清高密度脂蛋白表达与妊娠结局进行关联分析。结果:妊娠28周时观察组空腹血糖(5.64±0.79mmol/L)高于对照组(4.46±0.50mmol/L),餐后1h、2h血糖水平高于对照组,收缩压和舒张压(156.68±13.94mmHg、7.66±9.07mmHg)高于对照组,血清高密度脂蛋白(1.36±0.29mmol/L)低于对照组(1.80±0.33 mmol/L),低密度脂蛋白、甘油三酯和胆固醇水平均高于对照组(P<0.05)。观察组中高密度脂蛋白水平小于正常值孕妇顺产比例(51%)低于正常水平孕妇,产后出血发生率(8.1%)高于正常水平者(0.0%)(P<0.05),但阴道助产、剖宫产及新生儿窒息和死胎发生率与高密度脂蛋白水平高低未差异。多因素回归分析显示,高密度脂蛋白水平异常减低,空腹血糖水平、低密度脂蛋白水平及收缩压异常增高等均与不良妊娠发生有关。结论:妊娠期糖尿病合并妊娠高血压综合征孕妇血清高密度脂蛋白异常降低,且与顺产及产后出血发生存在关联,值得临床关注。

Objective:To investigate the expression features of serum high-density lipoprotein(HDL)of pregnant women with gestational diabetes mellitus(GDM)and pregnancy-induced hypertension syndrome,and to study its predictive value for pregnancy outcomes.Methods:In this study,95 pregnant women with GDM and pregnancy-induced hypertension syndrome were selected in observation group from 2014 to 2016,and 100 healthy pregnant women were selected in control group.The fasting blood glucose,OGTT,high-density lipoprotein(HDL)level,and blood pressure of the women in the two groups were measured.And the relationship between serum HDL expression of the women in the observation group and their pregnancy outcomes was analyzed.Results:The fasting glucose level of women in the 28 th gestational weeks in the observation group was 5.64±0.79 mmol/L,which was significant higher than that(4.46±0.50 mmol/L)of women in the control group.The values of systolic and diastolic blood pressure of women in the observation group were 156.68±13.94 mmHg and 7.66±9.07 mmHg,which were significant higher than those of women in the control group.The serum HDL level of women in the observation group was 1.36±0.29 mmol/L,which was significant lower than that(1.80±0.33 mmol/L)of women in the control group.The blood glucose level 1 hour and 2 hours after dinner,and the levels of low density lipoprotein(LDL),triglyceride and cholesterol women in the observation group were significant higher than those of women in the control group.The proportion of vaginal delivery of women with low HDL level was 51%,which was significant lower than that of women with normal HDL level.The incidence of postpartum hemorrhage of women with lowr HDL level 8.1%,which was significant higher than that of women with normal HDL level(P<0.05).There were no significant different in the incidences of vaginal midwifery,cesarean section,neonatal asphyxia,and sillbirth between the women with low HDL level and the women with normal HDL level.The multivariate regression analysis showed that the abnormal HDL level decreased,fasting blood glucose level,LDL level and abnormal systolic blood pressure increased of women were associated with their adverse pregnancy outcomes.Conclusion:The HDL level of pregnant women with GDM and pregnancy induced hypertension syndrome is significantly has decreased,which is related to the the proportion of normal vaginal delivery and postpartum hemorrhage,so it is should be paid more attention to in the clinical practice.