孕期血脂参考值范围及其与妊娠结局的相关性分析  

Correlation analysis of blood lipid reference range and pregnancy outcome during pregnancy

作　　者：戴珊[1] 戴楠[1] 

机构地区：[1]江苏省丹阳市人民医院,212300

出　　处：《齐齐哈尔医学院学报》2017年第20期2442-2444,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨孕期妇女血脂的参考值范围,并研究孕期血脂水平与不良妊娠结局的关系。方法选择2013年3月至2015年8月在本院进行常规产检并住院分娩的732名早孕期孕妇作为研究对象,通过问卷调查追踪其孕早、中、晚期的血脂状况并收集孕期并发症和妊娠结局。用酶比色法检测孕妇血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)浓度。对于TG,TC,LDL-C,取血脂分布的75%位数以下为推荐值,高于90%位数为血脂异常。对于HDL-C,取25%位数以上为推荐值,低于25%位数为血脂异常。通过多元logistic回归,分析通过本参考值范围得出的血脂异常与母婴不良妊娠及结局之间的关系。结果血脂参考值范围如下:孕早期:TC<4.60 mmol/L,TG<1.21 mmol/L,LDL-C<2.22 mmol/L,HDL>1.29 mmol/L;孕中期:TC<6.72 mmol/L,TG<2.76 mmol/L,LDL-C<3.47 mmol/L,HDL-C<1.67 mmol/L;孕晚期:TC<7.09 mmol/L,TG<4.20 mmol/L,LDL-C<3.80 mmol/L,HDL-C>1.59 mmol/L。孕晚期血清异常TC、TG和HDL-C分别使孕妇肝内胆汁淤积症(ICP)、高血压综合征(HDP)和巨大儿发生的风险增加6.4、2.3和0.78倍。结论本研究为孕期血脂参考值范围的建立提供了一些参考数据。根据本参考值范围定义的异常TC、TG和HDL-C水平分别和ICP、HDP和巨大儿的发生显著相关。Objective To study the range of reference value of blood lipid in pregnant women,and to study the relationship between the level of blood lipid and the outcome of bad pregnancy.Methods During March 2013 to August 2015,732 pregnant women during early pregnancy who got regular antenatal care in Danyang People＇s Hospital were recruited and followed until delivery. Questionnaires were completed by pregnant women in order to track the serum lipid levels during the three semesters of pregnancy and to get the information of pregnancy complications and outcomes. Serum samples from pregnant women were assayed by enzyme colorimetry for fasting total cholesterol（ TC）,triglycerides（ TG）,low-density lipoprotein cholesterol（ LDL-C） concentration,high-density lipoprotein cholesterol（ HDL-C）. For TG,TC and LDL-C,we define the reference ranges was below the 75% percentiles and the abnormal range was above 90% percentiles. For HDL-C,the reference ranges was above 25% percentile and the abnormal range was below 25% percentile. Associations of abnormal serum lipid concentration defined by the established reference range with adverse outcomes were then analyzed by multiple logistic regression.Results Reference ranges for serum lipid： the first trimester： TC 4. 60 mmol/L,TG 1. 21 mmol/L,LDL-C2.22 mmol/L,HDL1.29 mmol/L; the second trimester： TC6.72 mmol/L,TG2.76 mmol/L,LDL-C3. 47 mmol/L,HDL-C 1. 67 mmol/L; the third trimester： TC 7. 09 mmol/L,TG 4. 20 mmol/L,LDL-C3.80 mmol/L,HDL-C 1. 59 mmol/L. The abnormal serum levels of TC,TG and HDL-C in the third trimester increased the risk of intrahepatic cholestasis（ ICP）,hypertension syndrome（ HDP） and macrosomia in pregnant women by 6.4,2.3 and 0.78 times respectively. Conclusions This study provides some reference data for the establishment of the range of blood lipid reference values during pregnancy. The abnormal TC,TG,and HDL-C levels defined according to the range of reference values are significantly related to the occurrence of ICP,HDP and the occurren

关 键 词：血脂 妊娠 相关性 

分 类 号：R714.251[医药卫生—妇产科学]