正常妊娠及妊娠高血压综合征患者血清脂质和载脂蛋白的分析

目的：探讨正常妊娠和妊娠高血压综合征（妊高征）患者血脂和载脂蛋白改变。以及这些改变与妊高征发病的关系。方法：采用酶法和免疫扩散法，对28例妊高征孕妇，31例正常孕妇及24例未孕妇女血脂和载脂蛋白进行了检测。分别测定了甘油三酯（TG），胆固醇（TC），高密度脂蛋白胆固醇（HDL－C），载脂蛋白（apo)AI,B100,CⅡ，CⅢ和E，并计算非HDL－C（nHDLC)和TG/HDL-C秕值，结果：（1）与未孕妇女比较，正常妊娠36－42周妇女血清TG,apoCⅡ及apoCⅢ水平分别升高了3．5倍，2．4倍和2．8倍（P＜0．001），血清TC升高21％（P＜0．01），血清HDL－C未见明显改变，nHDL-C升高33％（P＜0．05），apoA,I,apoB100及apoE分别升高了55％，79％和77％（P＜0．001），TG／DHL－C比值显著增加（P＜0．01），（2）与未孕妇女比较，妊高征组妊娠32－42周妇女血清TG，apoCII及apo CⅢ亦分别升高2＝3倍，4．0倍和2．8倍（P＜0．01），血清TC仅升高27％（P＜0．01），HDL－C升高29％（P＜0．05），nHDL-C升高26％（P＜0．05）；apoAI,apoB100及apoE分别升高52％，90％和67％（P＜0．001），TG／HDL－C比值亦显著增加（P＜0．01），与正常妊娠组比较，妊高征组血脂和载脂蛋白水平平均未见明显差异。（3）不同程度妊高征及正常妊娠对照血脂和载脂蛋白含量的比较显示，妊高征患者各亚组血脂和载脂蛋白的含量不随病情的严重程度而升高。结论：妊娠时胎盘分泌的大量雌性激素是导致正常妊娠及妊高征患者血脂及载脂蛋白显著升高的主要原因，妊娠时血脂及载脂蛋白的升高可能与妊高征的发病无关。

Analysis of serum lipid and apolipoprotein levels in pregnancy-induced hypertension and normotensive pregnant women]

OBJECTIVE: To investigate the serum lipid and apolipoprotein levels in pregnancy-induced hypertension (PIH or pre-eclampsia), normotensive pregnant women and non-pregnant women. METHODS: Twenty-eight women with PIH, 31 normatensive and 24 non-pregnant ones were studied, from whom maternal blood samples were collected. Serum lipid levels were measured by enzymatic method and apolipoproteins AI, B100, C II, CIII and E levels by radial immunodiffusion kits developed by our Lab. RESULTS: 1. Serum TG, apoC II and apoC III were highly increased in normotensive pregnant women by 3.5, 2.4 and 2.8 times respectively, when compared with those in non-pregnant ones (P < 0.001); serum TC, nHDL-C and apoAI, B100 and E were also increased in normotensive pregnant women by 21%, 33%, 55%, 79% and 77% respectively, when compared with those in non-pregnant ones (P < 0.001). TG/HDL-C in normotensive pregnant women was also significantly, higher than that in non-pregnant ones(P < 0.01). Serum HDL-C levels remained unchanged in both groups. 2. Serum TG, apoC II and apoC III were highly increased in PIH patients by 2.3, 4.0 and 2.8 times respectively, when compared with those in non-pregnant ones (P < 0.001); serum TC, nHDL-C and apoAI, B100 and E were also increased in PIH patients by 27%, 26%, 52%, 90% and 67% respectively, when compared with those in non-pregnant ones (P < 0.001) TG/HDL-C in PIH patients was also significantly higher than that in non-pregnant ones (P < 0.01). Serum HDL-C levels were increased in PIH patients by 29%, when compared with non-pregnant women. Only serum HDL-C level in PIH patients was higher than that in normotensive pregnant women. No significant differences were seen in other lipid and apolipoprotein levels between PIH patients and normotensive pregnant ones. 3. There was no significant difference in the levels of serum lipid and apolipoprotein between the subgroups of PIH patients according to the severity of the disease. CONCLUSION: The increase of serum lipid and apolipoprotein levels in PIH is probably not the predictor for pre-eclampsia.