子痫前期患者血脂代谢调节的探讨

目的:探讨子痫前期患者脂代谢调节水平及其异常调节情况。方法:采取前瞻性研究方法,随机抽取317例正常孕妇,分别测定不同妊娠周数的血脂和游离脂肪酸(FFA)水平;选取产前规律检查的正常孕妇54例,分别于孕10~14周,20~24周及30~34周测定血脂代谢水平。并随机抽取孕周相同、年龄相同或相近的正常孕妇77例与重度子痫前期77例进行1:1配对研究,比较血脂代谢变化。结果:正常妊娠妇女血清中TG、TCHO和LDL水平随妊娠周数增加而增加,但FFA和HDL水平并未随妊娠的周数的增加而发生明显变化。重度子痫前期TG和FFA水平较对照组明显升高(P<0.05),而HDL水平下降(P<0.05);FFA/HDL和LDL/HDL比值较对照组明显升高(P<0.05),而FFA/TG、FFA/LDL及FFA/TCHO比值无明显变化(P>0.05)。早发型重度子痫前期患者中肝功损害组的TCHO和LDL水平较对照组明显增高(P<0.05)。结论:重度子痫前期患者存在脂质代谢调节异常,具有损伤作用的FFA增加,而具有保护作用的HDL下降,FFA/HDL比值升高,重度子痫前期正常的血脂代谢平衡发生变化,FFA增加可能在重度子痫前期脂质代谢异常调节方面起到一定作用。

The regulation mechanism of the lipid metabolism in preeclampsia

Objective:To explore the abnormal regulation mechanism of the lipid metabolism in severe preeclampsia.Methods:Prospective study was carried out in this study.Serum concentrations of lipids were measured in 317 cases of normal pregnant women sampling at various gestational age.Consecutive measurement was performed in 54 cases of normal pregnant women during 10~14,20~24 and 30~34 gestational weeks.Case control study was performed between 77cases with severe preeclampsia(S-PE) and 77 normal pregnant women.Results:Serum concentrations of FFA and HDL kept stable in normal pregnant women.TG,TCHO and LDL levels elevated as gestational age increased.Serum concentrations of TG and FFA in S-PE were significantly higher than those in control group(P<0.05),however serum concentration of HDL was significantly decreased in S-PE than that in controls(P<0.05).There were no difference on the ratio of FFA/TG,FFA/LDL and FFA/TCHO between S-PE and controls(P>0.05),but the ratio of FFA/HDL and LDL/HDL in S-PE was much higher than that in control group(P<0.05).The levels of TCHO and LDL in cases of early onset of S-PE with damage of liver function were higher than that in normal control groups(P<0.05).Conclusion:Abnormal regulation of lipid metabolism may play a role in the development of severe preeclampsia.