摘要
目的:探讨产妇孕早期血清中同型半胱氨酸和血脂水平检测对重度子痫前期(sPE)的预测价值.方法:选取2020年12月至2022年12月在本院建卡,进行系统产检,并在本院进行生产的 68 例产妇作为研究对象.孕早期(11～12周)抽取空腹血,检查同型半胱氨酸(Hcy)、叶酸、维生素B12(VB12)和血脂水平,将最终发展成为sPE的产妇纳入sPE组(n=34),将正常足月分娩、血压正常、未发生妊娠并发症的正常产妇纳入对照组(n=34).比较两组产妇Hcy、叶酸、VB12及血脂的水平的差异,并对两组产妇进行logistic回归分析.结果:两组孕妇年龄、身体质量指数(BMI)、初产妇、分娩孕周、出生体重比较,差异均有统计学意义(P＜0.05).sPE组的血清Hcy和甘油三酯(TG)、载脂蛋白-B(Apo-B)浓度明显高于对照组,而血清叶酸水平明显低于对照组,差异均有统计学意义(P＜0.05).年龄和Hcy指标是sPE的危险因素(P＜0.05).结论:产妇生产的年龄是导致子痫前期发生率增加的危险因素,Hcy是发生sPE的危险因素,孕早期联合检测Hcy、TG等指标可预测其后发生sPE的风险.
Abstract
Objective:To explore the predictive value of serum homocysteine and lipid in early pregnancy for severe preeclampsia(sPE).Methods:A total of 68 postpartum women who were registered in our hospital from December 2020 to December 2022,underwent systematic prenatal check ups,and gave birth in our hospital were selected as the research subjects.Fasting blood samples were collected during early pregnancy(11～12 weeks)to check homocysteine(Hcy),folate,vitamin B12(VB12),and blood lipid levels.Pregnant women who eventually developed sPE were included in the sPE group(n=34),while normal full-term delivery,normal blood pressure,and no pregnancy complications were included in the control group(n=34).Compare the differences in Hcy,folate,VB12,and blood lipid levels between two groups of parturients,and perform logistic regression analysis on the two groups of parturients.The levels of Hcy,folate,VB12 and blood lipids were compared between the two groups.Logistic regression analysis was performed on the two groups of the parturients.Results:There were differences in maternal age,body mass index(BMI),primipara,gestational age and birth weight between the two groups(P＜0.05).Serum Hcy,triglyceride(TG)and apolipoprotein B(Apo-B)concentrations in sPE group were significantly higher than those in control group,while serum folate levels were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).Age and Hcy markers were risk factors for the sPE(P＜0.05).Conclusion:Homocysteine is the risk factor for the sPE.First-trimester Hcy and lipids combined with maternal characteristics are promising markers in the risk assessment of the sPE.
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