妊娠期高血压疾病患者孕中期血脂变化及对妊娠结局的影响

Changes of blood lipids in the second trimester of pregnancy in patients with pregnancy induced hypertension and its influence on pregnancy outcome

目的研究妊娠期高血压疾病患者孕中期血脂变化及对妊娠结局的影响。方法选取30例妊娠期高血压疾病孕中期患者设为研究组,同时选取同一时期入院进行产检的30例健康孕妇作为对照组。比较两组血脂指标[脂蛋白a(LPa)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)]水平与研究组不同孕期血脂指标水平,并比较两组妊娠结局、新生儿结局。结果研究组ApoA1、HDL-C水平较对照组更低,LPa、ApoB、LDL-C、TG、TC水平较对照组更高(P<0.05)。研究组患者孕中期ApoA1、HDL-C水平较孕早期更低,LPa、ApoB、LDL-C、TG、TC水平较孕早期更高(P<0.05)。研究组早产率、胎膜早破率、剖宫产率较对照组更高(P<0.05)。研究组新生儿低体质量率、新生儿窒息率较对照组更高(P<0.05)。结论妊娠期高血压疾病患者孕中期血脂指标水平变化十分显著,伴脂质代谢异常,可增加不良妊娠结局发生风险。

Objective To study the changes of blood lipids in the second trimester of pregnancy in patients with pregnancy induced hypertension(PIH)and its influence on pregnancy outcome.Methods 30 patients with PIH in the second trimester of pregnancy were selected as the study group,and 30 healthy pregnant women in the same period were selected as the control group.The levels of blood lipid indicators[lipoprotein a(LPa),Apolipoprotein AI(ApoA1),Apolipoprotein B(ApoB),High-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triacylglycerol(TG),and total cholesterol(TC)]between the two groups and the levels of blood lipid indicators in different pregnancy periods of the study group were compared.And the pregnancy outcomes and neonatal outcomes between the two groups were compared.Results The levels of ApoA1 and HDL-C in the study group were lower than those in the control group,and the levels of LPa,ApoB,LDL-C,TG and TC were higher than those in the control group(P<0.05).In the study group,the levels of ApoA1 and HDL-C in the second trimester were lower than those in the first trimester,and the levels of LPa,ApoB,LDL-C,TG and TC were higher than those in the first trimester(P<0.05).The rate of premature delivery,premature rupture of membranes and cesarean section in the study group were higher than those in the control group(P<0.05).The rates of low body mass and neonatal asphyxia in the study group were higher than those in the control group(P<0.05).Conclusion The level of blood lipid index in patients with PIH in the second trimester of pregnancy changes significantly,with abnormal lipid metabolism,which can increase the risk of adverse pregnancy outcomes.