妊娠早期血脂、脂蛋白相关磷脂酶A2水平表达对妊娠期合并症预测价值分析

The predictive value of blood lipids and Lp-PLA2 for pregnancy complications at early pregnancy

目的分析妊娠早期血脂、脂蛋白相关磷脂酶A2(Lp-PLA2)对妊娠期合并症的预测价值。方法选取2017年6月至2018年6月于我院住院分娩的GH孕妇300例为妊娠期高血压(GH)组、妊娠期糖尿病(GDM)孕妇200例为GDM组、正常妊娠孕妇1500例为对照组,比较3组一般资料、孕16~18周、孕26~28周血脂[甘油三酯(TG)、总胆固醇(TC)、高度密脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]、血清Lp-PLA2水平,分析妊娠期合并症发生的影响因素,探讨血脂、Lp-PLA2对妊娠期合并症的预测价值。结果孕16~18周、孕26~28周GDM组与GH组的血清TG、TC、Lp-PLA2以及孕26~28周血清LDL-C高于对照组,孕26~28周血清HDL-C低于对照组(P<0.05)。孕16~18周、孕26~28周血清TG、Lp-PLA2升高是妊娠期合并症发生的独立危险因素(P<0.05)。孕16~18周血清TG、Lp-PLA2联合预测妊娠期合并症的AUC为0.852,敏感性、特异性分别为72.00%、88.00%。结论血清TG、Lp-PLA2水平是妊娠期合并症发生的危险因素,二者联合检测可为临床预测妊娠期合并症、选取个性化干预手段、促进妊娠结局改善提供一种有效辅助手段。

Objective To analyze the predictive value of lipid and lipoproteinassociated phospholipase A2(LP-PLA2)for pregnancycomplications in early stage of pregnancy.Methods From June 2017 to June 2018,300 with gestational hypertension women were selected as the gestational hypertension(GH)group,200 gestational diabetes mellitus(GDM)women were selected as the GDM group,and 1500 normal pregnant women were selected as the control group in this retrospective study.The women were hospitalized in our hospital for delivery.General data and the blood lipids such as triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),and serum Lp-PLA2 at 16~18 weeks and 26~28 weeks of gestation of the 3 groups were analyzed.The influence factors for complication during pregnancy were analyzed and the predictive value of blood lipid and LP-PLA2 for pregnancy complications was explored.Results The serum TG,TC and Lp-PLA2 at 16~18 and 26~28 weeks of gestation and LDL-C at 26~28 weeks of gestationin the GDM and the GH group were higher than those in the control group while the serum HDL-C at 26~28 weeks of gestation was lower than that in the control group(P<0.05).The increased serum TG and Lp-PLA2 at 16~18 and 26~28 weeks of pregnancy were independent risk factors for the occurrence of complications during pregnancy(P<0.05).The AUC of combination of serum TG and Lp-PLA2 at 16~18 weeks for prediction of pregnancy complications was 0.852.The sensitivity and specificity were 72.00%and 88.00%,respectively.Conclusion The levels of serum TG and Lp-PLA2 are risk factors for the occurrence of complications during pregnancy.The combined detection of the two indexes can provide an effective auxiliary means for clinical prediction of complications in pregnancy,selection of personalized intervention methods and improvement of pregnancy outcome.