黄思玲, 桑琳. 孕期体质量增值、血脂水平与孕妇妊娠期高血压靶器官损害及妊娠结局的关联性分析[J]. 蚌埠医科大学学报, 2021, 46(7): 907-912. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.017
    引用本文: 黄思玲, 桑琳. 孕期体质量增值、血脂水平与孕妇妊娠期高血压靶器官损害及妊娠结局的关联性分析[J]. 蚌埠医科大学学报, 2021, 46(7): 907-912. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.017
    HUANG Si-ling, SANG Lin. Correlation analysis of the body mass gain and blood lipid level during pregnancy with target organ damage of pregnancy hypertension and pregnancy outcome[J]. Journal of Bengbu Medical University, 2021, 46(7): 907-912. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.017
    Citation: HUANG Si-ling, SANG Lin. Correlation analysis of the body mass gain and blood lipid level during pregnancy with target organ damage of pregnancy hypertension and pregnancy outcome[J]. Journal of Bengbu Medical University, 2021, 46(7): 907-912. DOI: 10.13898/j.cnki.issn.1000-2200.2021.07.017

    孕期体质量增值、血脂水平与孕妇妊娠期高血压靶器官损害及妊娠结局的关联性分析

    Correlation analysis of the body mass gain and blood lipid level during pregnancy with target organ damage of pregnancy hypertension and pregnancy outcome

    • 摘要:
      目的探讨孕期体质量增值、血脂水平与孕妇妊娠期高血压靶器官损害及妊娠结局的关联性。
      方法选取85例妊娠期高血压孕妇作为研究组,随机选取同期60名正常孕妇作为对照组。统计比较2组一般资料,探讨妊娠期高血压发病的危险因素,比较研究组不同靶器官损害情况病人的孕期体质量增值、血脂水平,并分析孕期体质量增值、血脂水平与靶器官损害的关联性,随访至妊娠结束,统计研究组妊娠结局,比较妊娠结局良好与妊娠结局不良病人的孕期体质量增值、血脂水平,探究孕期体质量增值、血脂水平评估靶器官损害情况及预测妊娠结局不良的效能。
      结果研究组孕前体质量指数(BMI)、孕期体质量增值、高血压病家族史及三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均高于对照组(P<0.01),高密度脂蛋白胆固醇(HDL-C)水平低于对照组(P<0.05);妊娠期高血压发生的影响因素包括孕前BMI、孕期体质量增值、高血压病家族史及TG、TC、HDL-C、LDL-C水平(P<0.05~P<0.01);孕期体质量增值、TG、TC、LDL-C水平与靶器官损害呈正相关关系(P<0.01),HDL-C水平与靶器官损害呈负相关关系(P<0.05);孕期体质量增值、TG、TC、HDL-C、LDL-C水平联合评估靶器官损害情况的曲线下面积(AUC)为0.879,大于各指标单一评估,最佳评估敏感度、特异度分别为73.82%、92.40%;妊娠结局不良病人的孕期体质量增值、TG、TC、LDL-C水平高于妊娠结局良好病人,HDL-C水平低于妊娠结局良好患者病人(P<0.05);孕期体质量增值、TG、TC、HDL-C、LDL-C水平联合预测妊娠结局不良的AUC为0.932,大于各指标单一预测,最佳预测敏感度、特异度分别为88.89%、88.06%。
      结论孕期体质量增值、血脂水平与孕妇妊娠期高血压发病及靶器官损害密切相关,且能辅助临床评估靶器官损害情况、预测不良妊娠结局发生风险。

       

      Abstract:
      ObjectiveTo explore the correlation of the body mass gain and blood lipid level during pregnancy with target organ damage of pregnancy hypertension and pregnancy outcome.
      MethodsA total of 85 pregnant women with hypertension during pregnancy were set as the study group, and 60 normal pregnant women during the same period were randomly selected as the control group.The general data of two groups were statistically compared, and the risk factors of hypertension during pregnancy were investigated.The body mass gain and blood lipid level during pregnancy of patients with different target organ damage in study group were compared, and the correlation between the body mass gain, blood lipid level during pregnancy and target organ damage were analyzed.The study group was followed up to the end of pregnancy, and the pregnancy outcome of the study group was counted.The baody mass gain and blood lipid level during pregnancy were compared between patients with good and poor pregnancy outcomes and the efficacy of body mass gain and blood lipid level during pregnancy in assessing target organ damage and predicting poor pregnancy outcome were explored.
      ResultsBefore pregnancy, the body mass index(BMI), body mass gain during pregnancy, family history of hypertension, and levels of triglyceride(TG), total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C) in study group were higher than those in control group(P<0.01), and the high-density lipoprotein cholesterol(HDL-C) level in study group was lower than that in control group(P<0.05).The BMI before pregnancy, body mass gain during pregnancy, family history of hypertension, and levels of TG, TC, HDL-C and LDL-C were the influencing factors of hypertension during pregnancy(P<0.05 to P<0.01).The body mass gain during pregnancy, and levels of TG, TC and LDL-C were positively correlated with the target organ damage(P<0.01), and the HDL-C level was negatively correlated with target organ damage(P<0.05).The area under the curve (AUC) of body mass gain during pregnancy, and levels of TG, TC, HDL-C and LDL-C in the combined assessment of target organ damage was 0.879, which was greater than a single assessment of each index, and the best evaluation sensitivity and specificity were 73.82% and 92.40%, respectively.The body mass gain during pregnancy, and levels of TG, TC and LDL-C in patients with poor pregnancy outcome were higher than those in patients with good pregnancy outcome(P<0.05), and the HDL-C level in patients with poor pregnancy outcome was lower than that in patients with good pregnancy outcome(P<0.05).The AUC of body mass gain during pregnancy, and levels of TG, TC, HDL-C and LDL-C in the combined assessment of poor pregnancy outcome was 0.932, which was greater than a single assessment of each index, and the best evaluation sensitivity and specificity were 88.89% and 88.06%, respectively.
      ConclusionsThe body mass gain and blood lipid level during pregnancy are closely related to the onset of pregnancy-induced hypertension and target organ damage, and can assist the clinical assessment of target organ damage and predict the risk of adverse pregnancy outcome.

       

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