HDCP患者心肌酶谱与血脂指标的关联性研究

目的 探讨妊娠期高血压疾病(HDCP)患者心肌酶谱与血脂指标的关联性.方法 收集2014年1月1日至6月30日在深圳沙井医院就诊的91例HDCP患者,其中妊娠期高血压20例、轻度子痫前期45例、重度子痫前期26例,选择50例同期在医院正常分娩产妇作为对照组,测量各组血脂指标及心肌酶谱,对两种指标的相关性进行评估.结果 妊娠期高血压组、轻度子痫前期组、重度子痫前期组的体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A(Apo-A)、载脂蛋白B(Apo-B)、乳酸脱氢酶(LDH)、天门冬氨酸氨基转移酶(AST)及肌酸激酶(CK)与对照组比较差异均有统计学意义(t=1.845~13.482,均P<0.05);轻、重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与妊娠期高血压组比较差异均有统计学意义(t=1.663~14.258,均P<0.05);重度子痫前期组的BMI、LDL-C、TC、TG、HDL-C、Apo-A、Apo-B、LDH、AST及CK与轻度子痫前期组比较差异均有统计学意义(t=1.488~16.225,均P<0.05);对照组与各HDCP组脂蛋白a(Lpa)及肌酸激酶同工酶(CK-MB)组间比较差异均无统计学意义(均P>0.05).多因素相关分析表明,LDL-C、Apo-B均为AST和CK的独立相关因素(r2分别为0.513、0.497和0.391、0.445,均P<0.05).结论 HDCP患者血清中LDL-C、TC、TG、Apo-B、AST、LDH及CK均有所升高,HDL-C和Apo-A则明显下降,而且随着病情的加重变化更为明显,心肌酶谱指标AST和CK与LDL-C、Apo-B具有一定的相关性.

Correlation between myocardial zymogram and serum lipid parameters in patients with hypertensive disorders complicating pregnancy

Objective To investigate the correlation between myocardial zymogram and serum lipid parameters in patients with hypertensive disorder complicating pregnancy ( HDCP) .Methods A total of 91 cases of HDCP patients were collected, including 20 cases of gestational hypertension, 45 cases of mild preeclampsia and 26 cases of severe preeclampsia.All these cases received treatments at Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University from January 1st, 2014 to June 30th, 2014.A total of 50 cases of healthy puerperae who delivered their babies at the hospital at the same period were chosen as the control group.Serum lipid parameters and myocardial zymogram of both groups were measured to assess the correlation between two indexes.Results There were statistically significant differences between gestational hypertension group, mild preeclampsia group and severe preeclampsia group with the control group in body mass index (BMI), low-density lipoprotein cholesterol ( LDL-C), total cholesterol ( TC), triglyceride ( TG), high density lipoprotein cholesterol ( HDL-C) , apolipoprotein A ( Apo-A) , apolipoprotein B ( Apo-B) , lactate dehydrogenase ( LDH) , aspartate aminotransferase (AST) and muscle kinase (CK) (t value ranged from 1.845 to 13.482, all P<0.05).There were statistically significant differences in BMI, LDL-C, TC, TG, HDL-C, Apo-A, Apo-B, LDH, AST and CK between mild and severe preeclampsia group with gestational hypertension group (t value ranged 1.663-14.258, all P<0.05).The differences between mild and severe preeclampsia group in BMI, LDL-C, TC, TG, HDL-C, Apo-A, Apo-B, LDH, AST and CK were statistically significant ( t value ranged 1.488 -16.225, all P<0.05).There were no statistically significant differences in lipoprotein a (Lpa) and creatine kinase (CK-MB) between the control group and each HDCP group (all P>0.05).Multivariate analysis showed that LDL-C and Apo-B were independent correlative factors of AST and CK (r2 value was 0.513, 0.497, 0.391 and 0.445, respectively, all P<0.05).Conclusion There are slight increases in serum LDL-C, TC, TG, Apo-B, AST, LDH and CK in patients with HDCP.However, there are significant decreases in HDL-C and Apo-A. Meanwhile, the severer the patient' s disease condition is, the more evident the preceding changes are.There is certain correlation between indicators of myocardial zymogram, namely AST and CK with LDL-C and Apo-B.