妊高征孕妇的脂质代谢

对３４例妊高征孕妇、３０例健康未妊娠妇女及３５例正常孕妇的血脂代谢进行了检测，分别测定了胆固醇（ＴＣ）、甘油三酯（ＴＧ）、低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ）和高密度脂蛋白－胆固醇（ＨＤＬ－Ｃ），并计算ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值及动脉粥样硬化指数（ＡＩ）。结果：正常妊娠中期血脂水平与非孕妇血脂水平差异无显著性（Ｐ＞０．０５），妊娠晚期与非孕妇血脂水平及妊高征轻、中度与妊娠晚期血脂水平比较，差异均无显著性，Ｐ均＞０．０５，但重度妊高征ＴＧ和ＡＩ明显增高，其平均值加一个标准差＞３小于４。血脂水平与急性动脉粥样硬化及胎婴儿预后无明显相关。提示：（１）高脂血症分Ⅳ型，重度妊高征属Ⅳ型高脂血症。（２）妊娠期脂质代谢为妊娠晚期有大量胎肪积留，妊娠晚期血脂水平高于妊娠中期，可能为正常生理变化或与易发妊高征有关。（３）妊高征脂质代谢为重度妊高征ＴＧ和Ａｌ水平明显增高，胎盘血管粥祥硬化与ＴＧ增高导致脂质过氧化物增多或与免疫反应有关，其原因不明可能是多种因素的作用。     

妊高征患者血中内皮素与β-绒毛膜促性腺激素水平及其相互关系

目的 检测妊高征患者血清内皮素（ＥＴ）与β－绒毛膜促性腺激素（β－ｈＣＧ）水平及其相关关系,以探讨ＥＴ与β－ｈＣＧ在妊高征发病中的作用,方法 用放射免疫法对３２例妊高征患者（妊高征组）,１７例正常晚期单胎妊娠妇女（正常晚期妊娠组）以及１４例育龄期正常未妇女（正常未孕组）血中ＥＴ和β－ｈＣＧ水平进行检测。结果 妊高征组血ＥＴ和β－ｈＣＧ水平（３０．３５±１４．５２ｎｇ／Ｌ和７．３５±４．８６ｍｍｏｌ     

中度高原地区正常及妊高征孕妇血脂及脂质过氧化变化…

测定了未孕妇女、正常孕妇和妊高征患者的血胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白－－胆固醇（ＨＤＬ－Ｃ）及亚组（ＨＤＬ３－Ｃ、ＨＤＬ２－Ｃ），低密度脂蛋白－胆固醇（ＬＤＬ－Ｃ０、超氧化物皮化酶（ＳＯＤ）、丙二醛（ＭＤＡ）和维生素Ｅ（ＶＥ）的水平。结果显示：孕妇血中各项血脂均明显高于未孕妇女（Ｐ〈０．０１），妊高征组与正常孕妇组相比，ＴＣ、ＴＧ更高（Ｐ〈０．０１），ＨＤＬ－Ｃ有下降趋势，ＨＤＬ     

妊娠高血压综合征患者血清载脂蛋白的变化

目的　探讨妊娠高血压综合征患者血清载脂蛋白的变化及其与体质指数和新生儿体重的关系。　方法　以相同孕周的３１ 例孕妇作为对照,测定３６ 例妊高征患者血脂、脂蛋白和载脂蛋白ＡⅠ、ＡⅡ、Ｂ、ＣⅡ、ＣⅢ、Ｅ和脂蛋白（ａ）的变化,计算ＬＤＬＣ／ＨＤＬＣ、ＡｐｏＢ／ＡⅠ、ＡｐｏＡＩ／ＡⅡ、ＡｐｏＣⅡ／ＣⅢ;并观察与体质指数、新生儿出生体重的关系。　结果　妊高征组体质指数高于对照组（ Ｐ＜０．０１）,新生儿出生体重低于对照组（Ｐ＜ ０．０１） ,妊高征组ＴＧ、ＡｐｏＣⅡ、ＡｐｏＣⅢ和ＡｐｏＣⅡ／ＣⅢ高于对照组（ Ｐ＜ ０．０１） ,ＨＤＬＣ、ＬＤＬＣ低于对照组（ Ｐ＜０ ．０１）;妊高征组体质指数、新生儿出生体重与血脂指标失去相关关系。　结论　妊高征患者脂代谢紊乱,以甘油三酯及相关载脂蛋白变化最为显著。     

妊高征患者血浆D—二聚体的检测及临床意义

目的：探讨妊高征患者和正常妊娠妇女血浆Ｄ－二聚体的变化及临床意义。方法：用酶联免疫吸附试验，定量检测１０６例正常妊娠妇女（正常妊娠组）和５４例妊高征患者（妊高征组，其中轻、中度妊高征２５例，先兆子痫１８例，子痫１１例）血浆Ｄ－二聚体。结果：轻、中度妊高征患者血浆Ｄ－二聚体水平为２．２７±０．９２ｍｇ／Ｌ，显著高于正常妊娠组晚孕期（１．４５±０．３８ｍｇ／Ｌ，Ｐ＜０．０１）；先兆子痫患者血浆Ｄ－二聚体水平为３．０９±１．６５ｍｇ／Ｌ，显著高于轻、中度妊高征患者（Ｐ＜０．０１）；子痫患者血浆Ｄ－二聚体水平为５．６２±１．３４ｍｇ／Ｌ，显著高于先兆子痫患者（Ｐ＜０．０１）。结论：临床上动态检测中、晚孕期妊娠妇女血浆Ｄ－二聚体水平对妊高征的早期诊断有重要意义；监测妊高征患者血浆Ｄ－二聚体水平可预测疾病的预后。     

血清游离绒毛膜促性腺激素α与妊娠高血压综合征发病及脏器损害的关系

目的 探讨妊娠高血压综合征（妊高征）患者血清游离绒毛膜促性腺激素α亚单位（Ｆα－ｈＣＧ）水平与妊高征的严重程度及脏器损害的关系。方法 采用单克隆放射免疫法检测６６例妊高征患者（妊高征线，其中轻度５例，中度８例，重度５３例）；３０例同期无妊高征合并症的妊娠妇女（对照组）的血清Ｆα－ｈＣＧ水平，并行尿蛋白检测。用免疫组化半定量法测定两组孕妇中各１３例胎盘组织上Ｆα－ｈＣＧ的表达。结果 妊高征组Ｆα－ｈ     

妊高征胎盘绒毛组织内皮素-1及其mRNA表达和血浆内皮素-1的变化

目的探讨内皮素１（ＥＴ１）在妊高征发病中的作用。方法采用放射免疫法检测７０例妊高征患者（妊高征组）和３０例正常妊娠妇女（正常妊娠组）血浆ＥＴ１水平,用免疫组化及原位杂交方法检测ＥＴ１及ＥＴ１ｍＲＮＡ在妊高征及正常妊娠胎盘绒毛组织的表达。结果（１）妊高征组血浆ＥＴ１水平（７５０８±１６．３５）ｎｇ／Ｌ,明显高于正常妊娠组（４７６２±８６６）ｎｇ／Ｌ,病情越重其值越高,且ＥＴ１水平与妊高征患者平均动脉压呈正相关关系。（２）胎盘绒毛组织合体滋养细胞及胎儿血管内皮细胞有ＥＴ１及ＥＴ１ｍＲＮＡ的表达,且妊高征组胎盘绒毛组织ＥＴ１及ＥＴ１ｍＲＮＡ阳性信号较正常妊娠组增强。结论血管内皮损伤与妊高征的发病有关,胎盘绒毛组织ＥＴ１增高在妊高征的发病中起重要作用。     

妊高征患者血浆内皮素、过氧化脂质和红细胞超氧化物歧化酶活性的变化

目的：探讨内皮素－１（ＥＴ－１）和过氧化脂质（ＬＰＯ）在妊高征发病中的作用。方法：分别用放射免疫法、硫代巴比妥酸荧光微量法和邻苯二酚自氧化法，测定９５例妇女血浆ＥＴ－１、ＬＰＯ和红细胞超氧化物歧化酶（ＲＢＣ－ＳＯＤ）的活性。其中正常非妊娠妇女１５例（对照组），正常晚期妊娠妇女２０例（正常妊娠组），妊高征患者６０例（妊高征组）。结果：（１）正常妊娠组血浆ＥＴ－１、ＬＰＯ和ＲＢＣ－ＳＯＤ活性均高于对照组（Ｐ＜０．０１），但ＬＰＯ／ＲＢＣ－ＳＯＤ比值差异无显著性；（２）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值显著高于正常妊娠组，且随病情的加重而升高，产后３～７天迅速下降；（３）妊高征组的ＥＴ－１和ＬＰＯ／ＲＢＣ－ＳＯＤ比值呈正相关（ｒ＝０．８４６，Ｐ＜０．００１）。结论：提示机体内氧化和抗氧化平衡失调与内皮细胞损伤，在妊高征发病过程中起重要作用。     

妊高征患者血小板颗粒膜蛋白－140自身抗体及钙调素抗体的测定

应用酶联免疫吸附法，测定了４６例重度妊高征（妊高征组）及４０例正常孕妇（对照组）的血小板颗粒膜蛋白－１４０（ＧＭＰ－１４０）自身抗体和钙调素抗体（Ａ－ＣａＭ）；并对妊高征组２９例患者同时测定了ＧＰＩｂ／ＩＸ和ＧＰＩＩｂ／ＩＩｌａ。结果：妊高征组中１３例ＧＭＰ－１４０自身抗体阳性（２８．６％），其中８例血小板自身抗体阳性，１例与纯化ＧＭＰ－１４０反应，进行免疫印迹，在分子量１４００００处显示阳性区带。２９例同时测定ＧＭＩｂ／ＩＸ和ＧＰＩＩｂ／ＩＩＩａ，ＧＭＰ－１４０阳性者中，９例合并其它自身抗体。对照组中无１例ＧＭＰ－１４０阳性。妊高证组Ａ－ＣａＭ抗体较对照组明显升高。提示：部分妊高征患者血小板活化；Ａ－ＣａＭ参与妊高征的病理反应。重度妊高征患者血清钙凋素抗体达２０．０２±３．７４Ｖ／Ｌ，较正常孕妇７．５３±２．５７Ｕ／Ｌ明显升高（Ｐ＜０．０５）。     

妊娠期胆汁瘀积症患者脂质代谢及血液流变学变化

目的：探讨妊娠期胆汁瘀积症（ＩＣＰ）患者血清甘胆酸（ＣＧ）水平升高对脂质代谢及血液流变学的影响。方法：对６８例孕妇用放射免疫法测定血ＣＧ，酶法测定血总胆固醇（ＣＨ）、甘油三酯（ＴＧ）、高密度脂蛋－胆固醇（ＨＤＬ－Ｃ）、低密度脂蛋白－胆固醇ＬＤＬ－Ｃ及ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值，并测定全血比粘度高切（ＨＳ）、低切（ＬＳ）、血浆比粘度（ＰＶ）和红细胞压积（ＨＣＴ）。以血ＣＧ≥６μｍｏｌ／Ｌ为标准组成ＩＣＰ组（３５例）；血ＣＧ＜６μｍｏｌ／Ｌ为正常妊娠组（３３例）。另选取３０例非妊娠妇女作血ＣＧ及血脂水平检查的对照组。结果：除ＩＣＰ组ＨＤＬ－Ｃ外，两组ＣＧ及血脂水平均明显高于对照组（Ｐ＜０．０２～０．００１），ＩＣＰ组ＬＤＬ－Ｃ及ＬＤＬ－Ｃ／ＨＤＬ－Ｃ比值，以及血液Ｌ５、ＰＶ和ＨＣＴ均明显高于正常妊娠组（Ｐ＜０．０２～０．００１）。结论：ＩＣＰ患者脂质代谢和血液流变学均有明显变化，随着妊娠终止及血ＣＧ浓度降低，ＩＣＰ患者脂质代谢的病理生理改变得以改善，说明该病的病理生理变化与血清ＣＧ浓度增高有关。     

A Study of Lipoproteins in Normal and Pregnancy Induced Hypertensive Women in Tertiary Care Hospitals of the North West Frontier Province-Pakistan

Objectives. To evaluate the levels of serum lipoproteins in women with pregnancy-induced hypertension and compare it with the corresponding levels in pregnant women having normal blood pressure. Method. This cross-sectional study was conducted in the three tertiary care hospitals of Peshawar, North West Frontier Province, Pakistan. A total of 206 pregnant women at gestational age of >20 weeks were registered in the study after taking informed consent. All relevant information was recorded on a predesigned questionnaire. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C) and triglyceride (TG) levels were measured in 151 women with pregnancy induced hypertension (PIH) and compared with the corresponding values for a control group of 55 normotensive pregnant women. Result. Cholesterol levels were not statistically different between the patient group and controls. Triglyceride levels were significantly higher in the patient group than in controls. Women who developed hypertension after 20 weeks of gestation had 6.7, 4.2, 40.5, and 39.7% higher concentrations of TC, LDL-C, VLDL-C, and TG, respectively, and 28, 22.4, and 67.6% higher ratios of TC : HDL-C, LDL-C : HDL-C, and TG : HDL-C, respectively, as compared to the control subjects. The mean difference of the concentrations of HDL-C, VLDL-C, and TG, and the ratios TC : HDL-C, LDL-C : HDL-C, TG : HDL-C, and HDL-C : VLDL-C between the patients and control group was statistically significant. Conclusion. The assessment of blood lipids may be helpful in the prevention of complications in PIH patients.     

妊娠期糖代谢异常孕妇血脂水平与围产结局的关系

目的 分析妊娠期糖代谢异常孕妇血脂水平与围产结局的关系。方法选 择确诊为妊娠期糖代谢异常的孕妇358例,包括妊娠合并糖尿病（DM）28例（DM组）,妊娠期糖尿病（GDM）178例（GDM组）,妊娠期糖耐量受损（GIGT）152例（GIGT组）,用Beckman—CX9型全自动生化分析仪测定血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）及低密度脂蛋白胆固醇（LDL—C）,详细记录各组孕妇确诊时血脂水平及孕妇年龄、孕周、检测时间、治疗方法、并发症等。结果 （1）GIGT组与GDM组TG分别为（2．7±0．7）mmoL／L和（2．9±0．7）mmoL／L,TC分别为（6．2±1．1）mmol／L和（6．7±1．9）mmol／L,HDL—C分别为（1．78±0．22）mmol／L和（1．64±0．31）mmol／L,LDL-C分别为（3．8±0．9）mmol／L和（3．7±0．8）mmol／L,两两比较,差异均无统计学意义（P〉0．05）;DM组TG和LDL—C分别为（3．6±0．9）mmol／L和（4．8±0．6）mmol／L,均高于GIGT组和GDM组,而HDL-C[（1．24±0．19）mmol／L]低于GIGT组和GDM组,差异均有统计学意义（P〈0．05）。（2）DM组、GDM组、GIGT组,子痫前期发生率分别为35．7％（10／28）、16．8％（30／178）和14．5％（22／152）;早产发生率分别为39．3％（11／28）、16．8％（30／178）和19．7％（30／152）,分别比较,差异均有统计学意义（P均〈0．05）;羊水过多、胎膜早破发生率3组比较,差异无统计学意义（P〉0．05）;胎儿窘迫发生率GDM组低于GIGT和DM组,分别为9．8％（15／152）、20．2％（36／178）和21．4％（6／28）;GDM组和GIGT组巨大儿发生率高于DM组,分别为11．2％（20／178）、14．5％（22／152）和3．5％（1／28）,分别比较,差异均有统计学意义（P〈0．05）。结论 妊娠期糖代谢异常孕妇血脂水平是监测围产结局的有效指标之一,有效降低血脂水平能降低子痫前期和早产的发生率。     

妊娠期高血压疾病患者新生儿脐血血脂及脂蛋白水平及其意义

目的通过测定妊娠期高血压疾病(简称妊高病)患者新生儿脐血血脂和脂蛋白情况,探讨血脂和脂蛋白异常在其发病中的意义。方法选择2008年12月至2009年12月妊高病患者35例作为妊高病组,正常足月分娩无合并症和并发症孕妇35例作为对照组。采用酶试剂法测定两组新生儿脐血中甘油三酯(TG)、总胆固醇(TC)水平;清除法测定高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平;免疫透射比浊法测定载脂蛋白A1、B(apoA1、B)水平,并比较两组脐血中血脂和脂蛋白水平。结果①妊高病组新生儿脐血中TG、TC、LDL-C和apoB水平较对照组明显升高(P<0.05)。②妊高病组新生儿脐血中HDL-C和apoA1水平较对照组降低(P<0.05)。③随着妊高病病情的发展,脐血中TG、TC、LDL-C和apoB水平增高,HDL-C和apoA1水平降低。结论妊高病新生儿脐血中血脂及脂蛋白代谢紊乱,可能与孕妇妊高病的发病有关。     

Levels of lipoprotein and homocysteine in non-obese and obese patients with polycystic ovary syndrome.

AIM: This study was designed to examine the relationship between homocysteine (Hcy), lipoprotein levels and insulin resistance in obese and non-obese patients with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: Eighty-five patients (38 obese, 47 non-obese) with PCOS and 50 healthy subjects (25 obese, 25 non-obese) were included in the study. PCOS was defined according to the Homburg criterion. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), insulin, 17-hydroxyprogesterone, free testosterone, androstenedione, vitamin B12 and folate were measured. Also, serum concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), apoprotein B (Apo B) and apoprotein A (Apo A) were determined. Plasma Hcy levels were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA). RESULTS: Plasma Hcy levels were significantly higher in women with PCOS than in healthy women. HOMA-R (insulin resistance) was significantly higher in women with PCOS compared with healthy women. Serum fasting TC, LDL-C, TG, Apo B, vitamin B12 and folate levels were similar between PCOS and control groups. Lp(a) levels were higher in PCOS patients than in control subjects, whereas HDL-C and Apo A levels were lower. Compared with obese PCOS subjects, non-obese PCOS subjects had low HOMA-R, TC, LDL-C, TG, Apo B, Lp(a) and androgen levels. Plasma Hcy levels, serum HDL-C and Apo A levels were similar between obese and non-obese women with PCOS. Levels of HDL-C and Apo A were lower in both obese and non-obese PCOS patients than in obese and non-obese control subjects, whereas Lp(a) levels were higher. No correlation was observed between plasma Hcy, body mass index, HOMA-R, serum androgen levels, TC, LDL-C, HDL-C, Apo A, Apo B and Lp(a) levels. CONCLUSION: These results showed that elevated insulin resistance and plasma Hcy levels, and changes in serum lipid profile, which are possible risk factors for cardiovascular disorders, play important roles in the development of cardiovascular disease in both obese and non-obese patients with PCOS.     

2～14岁儿童血脂正常参考值研究

摘要：目的　探索建立2～14岁儿童血脂正常参考值及致动脉粥样硬化（AS）指数,并分析其相关关系。方法　随机选取2008年3月至2009年8月于重庆医科大学附属儿童医院体检的健康儿童988名,使用西门子2400型全自动生化分析仪检测儿童空腹血清总胆固醇（TC）、三酰甘油（甘油三酯,TG）、高密度脂蛋白胆固醇（HDL-C）及低密度脂蛋白胆固醇（LDL-C）水平,计算致AS指数LDL-C/HDL-C及TC、HDL-C的差值与HDL-C之比/［（TC－HDL-C）/HDL-C］。结果　（1）血脂紊乱诊断标准为2～ < 4岁： TC > 4.02 mmol/L, TG > 1.25 mmol/L, HDL-C < 0.83 mmol/L, LDL-C > 2.26 mmol/L;4～ < 7岁：TC > 4.47mmol/L,TG > 1.35mmol/L,HDL-C < 0.90 mmol/ L,LDL-C > 2.55 mmol/L;7～ < 10岁：TC > 4.78 mmol/L,TG > 1.42 mmol/L,HDL-C < 0.99 mmol/L,LDL-C > 2.49 mmol/L;10～ < 13岁：TC > 4.71 mmol/L,TG > 1.49 mmol/L,HDL-C < 0.89 mmol/L,LDL-C > 2.44 mmol/L;13～14岁：TC > 5.00 mmol/L,TG > 1.48 mmol/L,HDL-C < 0.95 mmol/L,LDL-C > 2.96 mmol/L;（2）由低至高5个年龄组致AS指数增高标准分别为：LDL-C/HDL-C > 2.38、1.98、1.95、2.35和2.28;（TC－HDL-C）/HDL-C > 2.59、2.55、2.11、2.46和2.50;（3）TC、HDL-C、LDL-C随着年龄的增长而升高;（4）致AS指数与TG及LDL-C呈明显正相关。结论　初步建立了重庆市区2～14岁儿童血脂水平正常参考值。儿童血脂水平处于动态变化过程中,应该重视致AS指数在儿童血脂异常中的预测价值。     

子宫内膜异位症患者血脂和钙磷代谢的变化及其临床意义

目的 探讨子宫内膜异位症(内异症)患者血脂和钙磷代谢的变化及其与内异症发病的关系.方法 回顾性分析223例内异症患者(其中年龄≤35岁148例,为内异症A组;＞35岁75例,为内异症B组)和200例非内异症患者(其中年龄≤35岁129例,为对照A组;＞35岁71例,为对照B组)的临床资料.应用电化学发光免疫分析法检测两组患者血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮、雌二醇和孕酮的水平;采用光电比色法检测血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、钙磷水平.结果 内异症A组和B组平均血清孕酮水平分别为2.0 nmol/L和1.8 nmol/L,均显著高于对照A组和B组的1.6 nmol/L和1.2 nmol/L,差异有统计学意义(P＜0.01);内异症B组血清LH水平为7.2 U/L,也显著高于对照B组的6.1 U/L,差异也有统计学意义(P＜0.01);而内异症A组血清LH水平(7.0 U/L)与对照A组(6.5 U/L)比较,差异无统计学意义(P＞0.05).内异症A组血清FSH、睾酮和雌二醇水平分别为6.2 U/L、1.1 nmol/L和269 pmol/L,与对照A组(6.3 U/L、1.1 nmol/L、264 pmol/L)分别比较,差异均无统计学意义(P＞0.05);内异症B组血清FSH、睾酮和雌二醇水平分别为6.6 U/L、1.0 nmol/L和345 pmol/L,与对照B组(6.6 U/L、0.9 nmol/L和279 pmol/L)比较,差异无统计学意义(P＞0.05).内异症A组和B组血清TG水平分别为0.71 mmol/L和0.72 mmol/L,均显著低于对照A组和B组的0.92 mmol/L和1.08 mmol/L,差异有统计学意义(P＜0.01);内异症A组和B组血清LDL水平分别为(2.2±0.5)mmol/L和(2.4±0.7)mmol/L,也均显著低于对照A组和B组[(2.4±0.6)mmol/L和(2.6±0.6)mmol/L],差异也有统计学意义(P＜0.01);而内异症A组和B组患者血清HDL水平[(1.62±0.31)mmol/L和(1.53±0.32)mmol/L]却均显著高于对照A组和B组[(1.48±0.21)mmol/L和(1.37±0.22)mmol/L],差异也有统计学意义(P＜0.01).但内异症A组和B组血清TC水平[(4.2±0.7)mmol/L和(4.4±0.8)mmol/L]与相应年龄段的对照A组和B组[(4.3±0.7)mmol/L和(4.5±0.7)mmol/L]比较,差异均无统计学意义(P＞0.05).另外,内异症A组和B组血磷水平[(1.01±0.22)mmol/L和(0.89±0.18)mmol/L]均显著低于对照A组和B组[(1.23±0.24)mmol/L和(1.10±0.13)mmol/L],差异有统计学意义(P＜0.01);而内异症A组和B组血钙水平[(2.39±0.23)mmol/L和(2.40±0.28)mmol/L]与相应年龄段的对照A组和B组[(2.41±0.12)mmol/L和(2.42±0.20)mmol/L]比较,差异均无统计学意义(P＞0.05).结论 内异症患者存在血脂和钙磷代谢的变化,血清高孕激素水平可能与内异症发病有关.     

脂源性细胞因子与子痫前期关系的研究

目的:探讨子痫前期(PE)患者血清脂源性细胞因子(脂联素和瘦素)水平的变化及其意义。方法:以53例子痫前期孕妇为研究组(其中轻度子痫前期32例、重度子痫前期21例),20例同期分娩的正常孕妇为对照组。采用ELISA法检测血清脂联素和瘦素水平。同时检测血清甘油三脂(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。结果:(1)轻度、重度子痫前期患者血清脂联素水平分别为8.88±4.67μg/m l及5.14±2.79μg/m l,明显低于对照组11.61±2.90μg/m l,差异有统计学意义(P<0.01)。而轻度、重度子痫前期患者血清瘦素水平为21.79±15.19ng/m l及27.27±18.38ng/m l,明显高于对照组的12.35±6.51ng/m l,差异有统计学意义(P<0.05,P<0.01),(2)子痫前期患者血清脂联素与TG、TC、LDL-C、HDL-C均显著相关(r分别为-0.658、-0.624、-0.419、0.461),瘦素水平也与上述指标显著相关(r分别为0.534、0.707、0.418、-0.513),(3)子痫前期患者血清脂联素及瘦素水平呈高度负相关(r=-0.760,P<0.01)。结论:脂联素、瘦素等脂源性细胞因子在PE的发病中可能起一定的作用。     

妊娠期糖尿病患者妊娠晚期血脂水平变化与新生儿出生体重的关系

目的探讨妊娠期糖尿病患者妊娠晚期血脂水平变化与新生儿出生体重的关系。方法采用酶法测定40例妊娠期糖尿病孕妇(妊娠期糖尿病组)、30例1型糖尿病孕妇(1型糖尿病组)、30例2型糖尿病孕妇(2型糖尿病组)及30例正常孕妇(正常妊娠组)妊娠晚期血脂水平。同时测定4组孕妇所分娩的新生儿出生体重。结果(1)妊娠期糖尿病组、1型糖尿病组、2型糖尿病组及正常妊娠组血清甘油三酯水平分别为(40±14)mmol/L、(29±08)mmol/L、(41±25)mmol/L及(27±09)mmol/L;总胆固醇水平分别为(65±30)mmol/L、(62±28)mmol/L、(64±32)mmol/L及(60±31)mmol/L;低密度脂蛋白胆固醇水平分别为(33±13)mmol/L、(32±13)mmol/L、(33±11)mmol/L及(32±10)mmol/L;高密度脂蛋白胆固醇水平分别为(16±05)mmol/L、(14±05)mmol/L、(15±04)mmol/L及(16±04)mmol/L。妊娠期糖尿病组及2型糖尿病组甘油三酯水平明显高于正常妊娠组及1型糖尿病组(P<001)。(2)妊娠期糖尿病组、1型糖尿病组、2型糖尿病组及正常妊娠组的新生儿出生体重分别为(4108±544)g、(3323±457)g、(4111±263)g及(3463±516)g。(3)妊娠期糖尿病组、1型糖尿病组、2型糖尿病组新生儿出生体重,与血清甘油三酯水平呈明显的正相关(r=039,P<001)。结论妊娠期糖尿病及2型糖尿病孕妇     

Levels of lipoprotein and homocysteine in non-obese and obese patients with polycystic ovary syndrome

Aim.?This study was designed to examine the relationship between homocysteine (Hcy), lipoprotein levels and insulin resistance in obese and non-obese patients with polycystic ovary syndrome (PCOS).

Materials and methods.?Eighty-five patients (38 obese, 47 non-obese) with PCOS and 50 healthy subjects (25 obese, 25 non-obese) were included in the study. PCOS was defined according to the Homburg criterion. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEA-S), insulin, 17-hydroxyprogesterone, free testosterone, androstenedione, vitamin B₁₂ and folate were measured. Also, serum concentrations of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), apoprotein B (Apo B) and apoprotein A (Apo A) were determined. Plasma Hcy levels were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA).

Results.?Plasma Hcy levels were significantly higher in women with PCOS than in healthy women. HOMA-R (insulin resistance) was significantly higher in women with PCOS compared with healthy women. Serum fasting TC, LDL-C, TG, Apo B, vitamin B₁₂ and folate levels were similar between PCOS and control groups. Lp(a) levels were higher in PCOS patients than in control subjects, whereas HDL-C and Apo A levels were lower. Compared with obese PCOS subjects, non-obese PCOS subjects had low HOMA-R, TC, LDL-C, TG, Apo B, Lp(a) and androgen levels. Plasma Hcy levels, serum HDL-C and Apo A levels were similar between obese and non-obese women with PCOS. Levels of HDL-C and Apo A were lower in both obese and non-obese PCOS patients than in obese and non-obese control subjects, whereas Lp(a) levels were higher. No correlation was observed between plasma Hcy, body mass index, HOMA-R, serum androgen levels, TC, LDL-C, HDL-C, Apo A, Apo B and Lp(a) levels.

Conclusion.?These results showed that elevated insulin resistance and plasma Hcy levels, and changes in serum lipid profile, which are possible risk factors for cardiovascular disorders, play important roles in the development of cardiovascular disease in both obese and non-obese patients with PCOS.