先兆子痫及正常妊娠血脂代谢与凝血-纤溶活性相互影响探讨  

The interaction between lipid metabolism and blood coagulative-fibrinolytic activities in preeclampsia and normal pregnancy

作　　者：王伽略[1] 杨孜[1] 王荣[1] 魏瑗[1] 

机构地区：[1]北京大学第三医院妇产科,100083

出　　处：《中国妇产科临床杂志》2006年第6期407-410,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家自然科学基金项目(30471821)资助

摘　　要：目的探讨正常妊娠血脂代谢和凝血-纤溶活性变化规律及其相互影响，探讨血脂代谢和凝血-纤溶活性变化在先兆子痫发病中的作用。方法采用前瞻性研究方法，选取规律产前检查的孕妇114例，分别于孕10～14周、20～24周及30～34周测定血脂水平及凝血相关指标，其中4例发生轻度先兆子痫（晚发型，发病孕周〉34周）。分析比较血脂及凝血相关指标。统计学方法采用t检验、重复测量方差分析及相关性分析方法。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（P〈0．01）；血FIB和D—Di—mer水平随妊娠周数的增加而升高、AT-Ⅲ水平下降（P〈0．01）。先兆子痫与正常妊娠相比，TG和TG／HDL比值水平明显升高，HDL、TCHO及LDL水平明显降低，但差异无显著性（P〉O．05）；FIB水平升高，差异无显著性（P〉0．05）。相关性检验显示，血TCHO、TG及LDL水平与血FIB及D—Dimer水平成正相关（P〈0．01），与AT-Ⅲ水平成负相关（P〈0．01）。正常妊娠AT-Ⅲ／TG比值随妊娠周数增加而下降（P〈0．01）。先兆子痫与正常妊娠相比，AT-Ⅲ／TG比值下降，FIB／HDL比值升高，但差异无显著性（P〉0．05）。结论正常妊娠脂质代谢和凝血-纤溶活性变化存在着相关性，先兆子痫患者存在脂质代谢和凝血-纤溶活性异常变化趋势，脂代谢与凝血-纤溶活性对先兆子痫的影响还需要大样本多中心的研究。Objective To investigate the changes of lipid metabolism and blood coagulative - fibrinolytic activities in normal pregnancy and their roles in pathogenesis of preeclampsia （PE）. Methods Prospective study was carried out in this study. Sera TG, TC, LDL, HDL, FIB, D - Dimer and AT -Ⅲ was measured consecutively in 114 normal pregnant women during 10 - 14, 20 - 24 and 30 -34 gestational weeks. Four of them developed late -onset PE mildly. Data were statistically analyzed by t - test, repeated measure ANOVA and correlation analysis. Resuits Sera TG, TCHO and LDL elevated as gestational age increased in normal pregnant women （P〈0.01）. FIB and D - Dimer were increased and AT -Ⅲ decreased as gestational age increased in normal pregnancy （P〈0.01）. Sera TG and TG/HDL ratio in PE were higher than those in control group but without statistically significant difference （P〈0.05）. Sera HDL, TCHO and LDL were less in preeclampsia than control group without statistically significant difference （P〈0.05）. FIB was higher in PE than that in control group without statistically significant difference （P〈0.05）. The correlation analysis indicated that TCHO, TG and LDL was positively associated with the levels of FIB and D - Dimer, and inversely associated with the levels of AT -Ⅲ significantly. The ratio of AT - Ⅲ/TG elevated as gestational age increased in normal pregnancy （P〈0. 01）. The ratio of AT -Ⅲ/TG was lower and FIB/HDL was higher in PE than those in control group without significant difference （P〈0.05）. Conclusions The lipid metabolism and blood coagulativefibrinolytic activities is related to gestational age in normal pregnancy. Abnormal changes of lipid metabolism and blood coagulative - fibrinolytic activities play roles in preeclampsia.

关 键 词：先兆子痫 脂质代谢 凝血活性 纤溶活性 

分 类 号：R714.2[医药卫生—妇产科学] R714.1[医药卫生—临床医学]