妊娠期脂代谢异常与子痫前期发生的相关性研究

Correlation between abnormal lipid metabolism during pregnancy and the occurrence of preeclampsia

目的分析妊娠期脂代谢异常与子痫前期发生的关系。方法回顾性选取2019年1月至2020年1月于新疆医科大学第一附属医院产检并分娩的53例子痫前期产妇作为观察组,并选取同期医院产检并分娩的53例正常产妇作为对照组。记录两组产妇妊娠早、中、晚期的脂代谢指标,分析其与子痫前期发生的关系。结果两组早、中、晚期的甘油三酯(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)水平比较,差异具有统计学意义(P<0.001);进一步两两比较发现,两组晚期TG、HDL-C、LDL-C分别与两组早期及中期比较,差异具有统计学意义(P<0.001),两组中期TC与观察组早期及对照组晚期比较,差异具有统计学意义(P<0.001),但观察组中期与晚期TC及对照组早期与中期TC比较,差异无统计学意义(P>0.05)。经Logistic回归分析结果显示,不同妊娠期脂代谢水平与子痫前期的发生有关,妊娠早、中、晚期TG、TC、LDL-C升高及HDL-C降低可能是子痫前期发生的风险因子(P<0.05);绘制受试者工作特征(ROC)曲线结果显示,妊娠早、中、晚期TG、TC、HDL-C、LDL-C水平预测子痫前期发生风险的AUC均>0.80。结论妊娠期血脂代谢水平异常与子痫前期的发生有关,可能是产妇发生子痫前期的风险因子。

Objective To analyze the relationship between abnormal lipid metabolism during pregnancy and the occurrence of preeclampsia. Methods A retrospective study was conducted to select 53 cases of puerpera with preeclampsia who delivered in the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2020 as the observation group, and 53 cases of normal puerpera who delivered in the hospital during the same period as the control group. The lipid metabolism indexes in early, middle and late pregnancy of two groups were recorded, and the relationship between them and the occurrence of preeclampsia was analyzed. Results The levels of TG, TC, HDL-C and LDL-C in early, middle and late stage were significantly different between the two groups(P<0.001). Further pairwise comparison showed, that the difference of TG, HDL-C and LDL-C in late stage compared with the early and middle stage between the two groups was statistically significant(P<0.001), and the difference between the middle TC of the two groups compared with the early observation group and the late control group was statistically significant(P<0.001). However, there was no significant difference between the middle TC and late TC in observation group, and early TC in control group(P>0.05). Logistic regression analysis showed that lipid metabolism levels at different stages of pregnancy were related to the occurrence of preeclampsia. The increase of TG, TC and LDL-C and the decrease of HDL-C in early, middle and late pregnancy may be the risk factors for the occurrence of preeclampsia(P<0.05). ROC curve showed that the AUC of TG, TC, HDL-C and LDL-C levels in early, middle and late pregnancy in predicting the risk of preeclampsia were all greater than 0.80. Conclusions Abnormal lipid metabolism during pregnancy is associated with the occurrence of preeclampsia and may be a risk factor for the occurrence of preeclampsia.