目的:探讨子痫前期(preeclampsia，PE)患者血脂代谢情况，为PE患者寻找早期诊断的血清标志物。方法:采取回顾性病例对照研究，分析2020年6月—2023年6月于厦门大学附属妇女儿童医院定期规律产检并分娩的454例妊娠期女性(孕周≥34周)，根据患者是否罹患PE将其分为PE组(n=175)和正常妊娠组(n=279)。比较两组清晨空腹血清总胆固醇(total cholesterol，TC)、甘油三酯(triglyceride，TG)、低密度脂蛋白(low density lipoprotein，LDL)、高密度脂蛋白(high density lipoprotein，HDL)、载脂蛋白A(apolipoprotein A，ApoA)及载脂蛋白B(apolipoprotein B，ApoB)、ApoA/ApoB、HDL/LDL水平，并采用受试者工作特征(receiver operating characteristic，ROC)曲线分析上述指标预测PE发生的诊断效能。结果:PE组HDL、ApoA、ApoA/ApoB及HDL/LDL均低于正常妊娠组，PE组LDL、TC、TG及ApoB均高于正常妊娠组，差异有统计学意义(P<0。05)。LDL、TC、TG、ApoB、ApoA、ApoA/ApoB、HDL/LDL对PE均有诊断价值(P<0。05)，其中ApoA/ApoB的诊断价值最高，敏感度为79。2％，特异度为68。0％，截断值为1。537(AUC=0。797，P<0。001);ApoB的诊断价值次之，敏感度为64。6％，特异度为79。9％，截断值为1。125 g/L(AUC=0。776，P<0。001)，结论:PE患者存在血脂代谢异常，这些血脂代谢可能参与了PE的发生发展，LDL、TC、TG、ApoB、ApoA、ApoA/ApoB、HDL/LDL对于PE均有诊断价值，其中ApoA/ApoB诊断价值最高，ApoB次之。
Blood Lipid Metabolism and Its Diagnostic Significance in Patients with Preeclampsia
Objective:To investigate the lipid metabolism of preeclampsia (PE) patients and to find serum markers for early diagnosis of PE patients.Method:A retrospective case-control study was conducted to analyze 454 pregnant women (gestational weeks ≥34 weeks) who had regular prenatal check-up and delivered in Women and Children's Hospital,School of Medicine,Xiamen University from June 2020 to June 2023.According to whether the patients suffered from PE or not,the patients were divided into PE group (n=175) and normal pregnancy group (n=279).Fasting serum total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL),high density lipoprotein (HDL),apolipoprotein A (ApoA) and apolipoprotein B (ApoB),ApoA/ApoB,HDL/LDL levels were compared between the two groups.Receiver operating characteristic (ROC) curves were used to analyze the diagnostic efficacy of these indicators in predicting PE.Result:HDL,ApoA,ApoA/ApoB and HDL/LDL in PE group were lower than those in normal pregnancy group,LDL,TC,TG and ApoB in PE group were higher than those in normal pregnancy group,the differences were statistically significant (P<0.05).LDL,TC,TG,ApoB,ApoA,ApoA/ApoB and HDL/LDL were all valuable in diagnosis of PE (P<0.05),ApoA/ApoB had the highest diagnostic value with sensitivity of 79.2％,specificity of 68.0％,cutoff value of 1.537 (AUC=0.797,P<0.001).ApoB B had the second diagnostic value,sensitivity 64.6％,specificity 79.9％,cutoff value of 1.125 g/L (AUC=0.776,P<0.001).Conclusion:PE patients have abnormal lipid metabolism,which may be involved in the occurrence and development of PE.LDL,TC,TG,ApoB,ApoA,ApoA/ApoB,HDL/LDL have diagnostic value for PE,ApoA/ApoB has the highest diagnostic value,ApoB is the second.
万方数据
维普
