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目的分析子痫前期与正常孕妇代谢综合征相关指标的差异,探讨子痫前期发病中的代谢性高危因素。方法以2012年1月至12月甘肃省妇幼保健院住院分娩的116例单胎子痫前期孕妇为研究组,按随机数字表法以1∶2配对,选择同期无合并症及并发症的正常孕妇232例为对照组。收集两组孕妇的体质指数(BMI)、血压、空腹血糖(FPG)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、载脂蛋白-A1(ApoA1)和载脂蛋白-B(ApoB)进行分析。结果研究组和对照组孕前BMI分别为(25.11±4.04)kg/m2和(21.28±2.42)kg/m2,两组比较,差异有统计学意义(P<0.01)。研究组入组时收缩压、舒张压分别为(149.29±14.02)mm Hg和(100.68±11.32)mm Hg,对照组分别为(109.29±10.34)mm Hg和(68.81±7.06)mm Hg,两组比较,差异均有统计学意义(P均<0.01)。研究组TG和ApoB分别为(4.40±1.93)mmol/L和(1.17±0.28)g/L,对照组分别为(3.34±0.93)mmol/L和(1.01±0.21)g/L,两组比较,差异均有统计学意义(P均<0.05)。研究组FPG、HDL-C和LDL-C、ApoA1分别为(4.15±1.62)mmol/L、(1.81±0.43)mmol/L、(3.15±1.01)mmol/L和(2.39±0.50)g/L,对照组分别为(3.95±1.13)mmol/L、(1.88±0.46)mmol/L、(2.96±0.84)mmol/L和(2.45±0.47)g/L,两组比较,差异均无统计学意义(P均>0.05)。研究组孕前BMI≥25kg/m2者占51.72%(60/116),高血糖占17.24%(20/116),对照组分别为6.47%(15/232)和0,两组比较,差异均有统计学意义(P均<0.01)。logistic回归分析显示,孕前BMI和TG与子痫前期发生的OR值分别为2.046(95%CI:1.214~3.450,P<0.01)和1.717(95%CI:0.795~3.706,P>0.05)。结论孕前BMI是子痫前期的危险因素。子痫前期患者中TG水平升高,而HDL-C浓度与正常孕妇无差异。
Objective To analyze the differences of metabolic syndrome-related indices in preeclampsia and normal pregnant women and to explore the metabolic risk factors in preeclampsia. Methods One hundred and sixty-one pregnant women with singletons and preeclampsia, who were hospitalized in Gansu Provincial Maternal and Child Health Hospital from January to December 2012, were selected as the study group. According to the random number table method, 1: 2 pairs of pregnant women with unwanted complications and complications 232 cases as control group. Body mass index (BMI), blood pressure, fasting blood glucose (FPG), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), apolipoprotein- A1 (ApoA1) and Apolipoprotein-B (ApoB). Results The BMI before and after pregnancy was (25.11 ± 4.04) kg / m2 and (21.28 ± 2.42) kg / m2 respectively in the study group and the control group. There was significant difference between the two groups (P <0.01). Systolic blood pressure and diastolic blood pressure were (149.29 ± 14.02) mm Hg and (100.68 ± 11.32) mm Hg respectively in the study group and were (109.29 ± 10.34) mm Hg and (68.81 ± 7.06) mm Hg respectively in the control group Comparison, the differences were statistically significant (P all <0.01). The levels of TG and ApoB were (4.40 ± 1.93) mmol / L and (1.17 ± 0.28) g / L in the study group and (3.34 ± 0.93) mmol / L and (1.01 ± 0.21) g / L in the control group , The differences were statistically significant (P all <0.05). The levels of FPG, HDL-C, LDL-C and ApoA1 in the study group were (4.15 ± 1.62) mmol / L, (1.81 ± 0.43) mmol / L, (3.15 ± 1.01) mmol / L and (2.39 ± 0.50) g / L (3.95 ± 1.13) mmol / L, (1.88 ± 0.46) mmol / L, (2.96 ± 0.84) mmol / L and (2.45 ± 0.47) g / L respectively in the control group. There was no significant difference between the two groups Significance (P> 0.05). In the study group, the pre-pregnancy BMI≥25kg / m2 accounted for 51.72% (60/116), hyperglycemia accounted for 17.24% (20/116), the control group were 6.47% (15/232) and 0, respectively, the difference was Statistical significance (P <0.01). Logistic regression analysis showed that the ORs of pre-pregnancy BMI and TG with preeclampsia were 2.046 (95% CI: 1.214-3.450, P <0.01) and 1.717 (95% CI: 0.795-3.706, P> 0.05) respectively. Conclusion Pre-pregnancy BMI is a risk factor for preeclampsia. TG levels were elevated in patients with preeclampsia, while HDL-C concentrations were not different from those in normal pregnant women.