不同孕期血脂值与妊娠并发症的关系  

Maternal Lipid Levels during Pregnancy and Their Relation with Pregnancy Complications

作　　者：岳书帆 裴玲 陈文湛 曾蕊 曹筱佩[1] YUE Shu-fan;PEI Ling;CHEN Wen-zhan;ZENG Rui;CAO Xiao-pei(Endocrinology and Metabolism Department,The First Affiliated Hospital,SUN Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院内分泌科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2021年第5期762-770,共9页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家重点研发计划项目(2018YFC1314100);中山大学5010临床研究项目(2017001);广州市科技计划项目(201803010101)。

摘　　要：【目的】探讨不同孕期的血脂值及其与妊娠期并发症的关系。【方法】纳入2018年1月至2018年8月期间在中山大学附属第一医院分娩及产检的孕妇1017例,分析不同孕期血脂水平。使用单因素Logistic回归模型检测妊娠期并发症的影响因素,多因素Logistic回归模型检测不同孕期的血脂水平与妊娠期并发症的发病风险。根据95%参考值范围计算出本院孕期血脂临界值。【结果】孕期血脂水平总体呈升高趋势,升高幅度最显著的是甘油三酯(TG)。年龄、孕前体质指数、血脂水平均与妊娠期并发症相关。在孕中、晚期,随着TG的升高,妊娠期并发症的发病风险升高;随着高密度脂蛋白胆固醇(HDL-c)的增高,妊娠期并发症的发病风险降低。本研究得出本院各孕期血脂临界值如下。孕早期:总胆固醇(TC)<6.09 mmol/L,TG<2.39 mmol/L,HDL-c>1.17 mmol/L,低密度脂蛋白胆固醇(LDL-c)<3.61 mmol/L;孕中期:TC<7.80 mmol/L,TG<3.51 mmol/L,HDL-c>1.38 mmol/L,LDL-c<4.73 mmol/L;孕晚期:TC<8.50 mmol/L,TG<5.61 mmol/L,HDL-c>1.28 mmol/L,LDL-c<5.25 mmol/L。【结论】孕期血脂值随孕期变化,孕中晚期TG水平升高、HDL-c水平下降与妊娠期并发症风险增加相关。【Objective】To determine the serum lipid levels during different trimesters of pregnancy and investigate their relation with pregnancy complications.【Methods】The study recruited 1017 pregnant women who were examined and delivered in the First Affiliated Hospital of Sun Yat-sen University between January 2018 and August 2018.Serum lipid levels during different trimesters of pregnancy were reviewed.Univariate and multivariate logistic regression models were used to analyze the risk factors of pregnancy complications and the relation between lipid levels and pregnancy complications.The threshold values of lipid levels during pregnancy were determined based on the 95 th percentile.【Results】Total lipid levels during pregnancy increased,with triglyceride(TG)levels increasing the most.Age,pre-pregnancy body mass index(p-BMI)and lipid levels were associated with pregnancy complications.In the second and third trimesters,the increased level of TG and decreased level of high-density lipoprotein cholesterol(HDL-c)were correlated with increased risk of pregnancy complications.The threshold values of lipid levels during pregnancy in our hospital were total cholesterol(TC)<6.09 mmol/L,TG<2.39 mmol/L,HDL-c>1.17 mmol/L and low-density lipoprotein cholesterol(LDL-c)<3.61 mmol/L in the first trimester;TC<7.80 mmol/L,TG<3.51 mmol/L,HDL-c>1.38 mmol/L and LDL-c<4.73 mmol/L in the second trimester;TC<8.50 mmol/L,TG<5.61 mmol/L,HDL-c>1.28 mmol/L and LDL-c<5.25 mmol/L in the third trimester.【Conclusions】Lipid levels vary with the stage of pregnancy.In the second and third trimesters of pregnancy,the increased level of TG and decreased level of HDL-c are associated with increased risk of pregnancy complications.

关 键 词：孕期血脂 参考值范围 妊娠期并发症 

分 类 号：R714.25[医药卫生—妇产科学]