目的 探讨正常妊娠女性血脂的动态变化特点。方法回顾性分析2015年1月1日至12月31日本院收治的771例正常妊娠孕妇的临床资料,同时选取同期本院妇科住院患者100例作为对照。收集产妇的年龄、身高、非孕期体重、孕晚期体重,孕早期(12^(+6...目的 探讨正常妊娠女性血脂的动态变化特点。方法回顾性分析2015年1月1日至12月31日本院收治的771例正常妊娠孕妇的临床资料,同时选取同期本院妇科住院患者100例作为对照。收集产妇的年龄、身高、非孕期体重、孕晚期体重,孕早期(12^(+6)周前)、孕中期(13～27^(+6)周)、孕晚期(≥28周)的血脂(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、脂蛋白a)测定结果。对血脂与体重、体重指数(body mass index,BMI)等因素的关系进行分析。结果①与正常非孕期女性相比,妊娠女性的血脂在孕早期即发生明显改变,表现为总胆固醇、低密度脂蛋白、载脂蛋白B下降(P均<0.05),甘油三脂、高密度脂蛋白、载脂蛋白A明显升高(P均<0.05),而脂蛋白a无明显变化(P>0.05)。②正常妊娠女性孕早、中、晚期血脂指标除脂蛋白a外(P=0.1399),其余均明显升高(各组指标经方差分析比较,P均<0.001),其中甘油三酯增加最为明显,孕晚期甘油三酯较孕早期增加3倍,而具有保护作用的载脂蛋白A/载脂蛋白B在孕晚期明显下降。③在孕早期,总胆固醇、甘油三酯、低密度脂蛋白、载脂蛋白B均与体重、体重指数及孕周呈正性相关(P<0.01),而除甘油三酯与年龄相关外,其余血脂指标与年龄、身高无相关性。在孕晚期,血脂仍受非孕期体重、BMI以及孕周影响,且大多数血脂增长程度(除高密度脂蛋白与载脂蛋白A)与早孕期体重、BMI均呈负性相关。体重增长的程度对血脂变化影响不大。结论正常妊娠女性自孕早期出现明显血脂变化,随孕周增加血脂呈不同程度上升,其中以甘油三酯升高最为明显。血脂受非孕期体重、BMI、孕周影响较大,但其增长与孕期体重增长无明显相关。展开更多
妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(Ame...妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(American College of Obstetricians and Gynecologists,ACOG)发布了'妊娠期高血压和子痫前期指南2019版”[1],本指南主要针对妊娠期高血压和子痫前期,在2013版指南[2]的基础上加入了最近几年该领域的研究进展,包括疾病的背景信息和处理建议两部分内容。现针对该指南第一部分内容解读如下。展开更多
Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high...Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy （HDP） and estimated the potential effect of anti-oxidants administration, including vitamin C （VC）, vitamin E （VE） and Salvia Miltiorrhiza L （SML）, a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy. Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups： 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group. Results （1）The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups （P〉0.05）. （2） In anti-oxidants group, the HDP morbidities among three subgroups： VC ＋ VE ＋ SML, VC ＋ VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies （P 〉0.05）. （3） The related index of factors affecting HDP showed in intensity sequence as follows： family HDP history 〉 profession 〉 education level 〉 age 〉 body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women （family HDP history, heavy physical labor, low education level （middle school and below）, age 〉40, body mass index 〉24） was 5.84%, which was obviously higher than that in normal population （P 〈0.01）. In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% （P〈0.01）. （4） In control group, the morbidity of HDP in women with family HDP history （especially with sisters＇）, heavy physical labor, middle school and below, age 〉35 was： 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group. Conclusions The high-risk factors prone to induce HDP included： family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.展开更多
文摘目的 探讨正常妊娠女性血脂的动态变化特点。方法回顾性分析2015年1月1日至12月31日本院收治的771例正常妊娠孕妇的临床资料,同时选取同期本院妇科住院患者100例作为对照。收集产妇的年龄、身高、非孕期体重、孕晚期体重,孕早期(12^(+6)周前)、孕中期(13～27^(+6)周)、孕晚期(≥28周)的血脂(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A、载脂蛋白B、脂蛋白a)测定结果。对血脂与体重、体重指数(body mass index,BMI)等因素的关系进行分析。结果①与正常非孕期女性相比,妊娠女性的血脂在孕早期即发生明显改变,表现为总胆固醇、低密度脂蛋白、载脂蛋白B下降(P均<0.05),甘油三脂、高密度脂蛋白、载脂蛋白A明显升高(P均<0.05),而脂蛋白a无明显变化(P>0.05)。②正常妊娠女性孕早、中、晚期血脂指标除脂蛋白a外(P=0.1399),其余均明显升高(各组指标经方差分析比较,P均<0.001),其中甘油三酯增加最为明显,孕晚期甘油三酯较孕早期增加3倍,而具有保护作用的载脂蛋白A/载脂蛋白B在孕晚期明显下降。③在孕早期,总胆固醇、甘油三酯、低密度脂蛋白、载脂蛋白B均与体重、体重指数及孕周呈正性相关(P<0.01),而除甘油三酯与年龄相关外,其余血脂指标与年龄、身高无相关性。在孕晚期,血脂仍受非孕期体重、BMI以及孕周影响,且大多数血脂增长程度(除高密度脂蛋白与载脂蛋白A)与早孕期体重、BMI均呈负性相关。体重增长的程度对血脂变化影响不大。结论正常妊娠女性自孕早期出现明显血脂变化,随孕周增加血脂呈不同程度上升,其中以甘油三酯升高最为明显。血脂受非孕期体重、BMI、孕周影响较大,但其增长与孕期体重增长无明显相关。
文摘妊娠期高血压疾病是全世界范围内导致孕产妇和围产儿死亡的重要原因之一,全球发病率在2%~8%。因其影响范围广泛、不良妊娠结局发生率高以及高昂的医疗花费,妊娠期高血压疾病一直是全球产科医生关注的重点。2019年美国妇产科医师学会(American College of Obstetricians and Gynecologists,ACOG)发布了'妊娠期高血压和子痫前期指南2019版”[1],本指南主要针对妊娠期高血压和子痫前期,在2013版指南[2]的基础上加入了最近几年该领域的研究进展,包括疾病的背景信息和处理建议两部分内容。现针对该指南第一部分内容解读如下。
文摘Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy （HDP） and estimated the potential effect of anti-oxidants administration, including vitamin C （VC）, vitamin E （VE） and Salvia Miltiorrhiza L （SML）, a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy. Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups： 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group. Results （1）The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups （P〉0.05）. （2） In anti-oxidants group, the HDP morbidities among three subgroups： VC ＋ VE ＋ SML, VC ＋ VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies （P 〉0.05）. （3） The related index of factors affecting HDP showed in intensity sequence as follows： family HDP history 〉 profession 〉 education level 〉 age 〉 body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women （family HDP history, heavy physical labor, low education level （middle school and below）, age 〉40, body mass index 〉24） was 5.84%, which was obviously higher than that in normal population （P 〈0.01）. In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% （P〈0.01）. （4） In control group, the morbidity of HDP in women with family HDP history （especially with sisters＇）, heavy physical labor, middle school and below, age 〉35 was： 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group. Conclusions The high-risk factors prone to induce HDP included： family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.
