天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (6): 759-762.doi: 10.11958/20150320

• 临床研究 • 上一篇    下一篇

孕前肥胖的早发型子痫前期患者临床特点与围产结局分析

吴璠， 华绍芳， 李月琴   

  1. 天津医科大学第二医院产科 （邮编 300211）
  • 收稿日期:2015-11-18 修回日期:2016-01-18 出版日期:2016-06-15 发布日期:2016-07-04
  • 基金资助:
    天津市卫生局科技基金资助项目 （2012kz084）

Analysis of clinical characteristics and perinatal outcomes in pre-pregnancy obesity patients with early-onset preeclampsia

WU Fan， HUA Shaofang， LI Yueqin   

  1. Department of Obstetrics, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2015-11-18 Revised:2016-01-18 Published:2016-06-15 Online:2016-07-04

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摘要： 摘要： 目的 探讨孕前肥胖的早发型子痫前期患者临床特点及对围产儿多系统的影响。方法 回顾分析我院产科住院的早发型子痫前期产妇 111 例， 按孕前体质指数（BMI）分为正常组（BMI＜28 kg/m2） 56 例和肥胖组（BMI≥ 28 kg/m2） 55 例， 比较 2 组产妇基础体质量、 基础 BMI、 孕期增重、 高危因素、 临床特征、 血脂指标及新生儿临床特点，并分析产妇血糖、 血脂指标与新生儿各指标的相关性。结果 肥胖组产妇更易发生血液浓缩和血脂代谢紊乱， 血脂水平、 糖化血红蛋白 （HbA1c）、 血细胞比容、 血小板及纤维蛋白原均显著高于正常组； 引发新生儿酸中毒及心脏等脏器损害， 肥胖组新生儿出生 Apgar 评分、 pH、 血糖显著低于正常组， 而剩余碱 （BE）、 乳酸 （LAC）、 肌酸激酶 （CK）、 肌酸激酶同工酶 （CKMB） 高于孕前正常组 （均 P＜0.05）； 相关分析示产妇低密度脂蛋白胆固醇 （LDL-C）、 总胆固醇 （TC）、三酰甘油（TG）及 HbA1c 与新生儿 Apgar 评分、 pH 呈负相关， 与新生儿 LAC、 CKMB 呈正相关（P＜0.05 或 P＜ 0.01）。结论 孕前肥胖的早发型子痫前期产妇所发生的脂代谢紊乱与母婴围产结局密切相关。

关键词: 先兆子痫, 肥胖症, 围生医学, 早发型子痫前期

Abstract: Abstract: Objective To explore clinical characteristics and the perinatal effects of multiple systems in prepregnancy obesity patients with early-onset preeclampsia. Methods A total of 111 cases with early-onset preeclampsia in our Inpatient Obstetric Department were reviewed in this study. According to pre- pregnancy body mass index (BMI), patients were divided into normal before pregnancy group (BMI＜28 kg/m2, n=56) and obese before pregnancy group (BMI≥ 28 kg/m2, n=55) . The body weight, BMI, weight gain during pregnancy, risk factors, clinical features, and clinical features of neonatal index were compared between two groups. The correlation between maternal and neonatal indexes and glucose and lipid indexes were compared. Results Obese before pregnancy was more prone to blood concentration and disorders of lipid metabolism. The serum levels of lipid, glycosylated hemoglobin (HbA1c), hematocrit, platelet and fibrinogen were significantly higher in obese before pregnancy group than than those of normal group. The induced neonatal acidosis and other organ damage, newborn Apgar score, pH, glucose were significantly lower in obese before pregnancy group than those of normal group. The residual alkali (BE), lactic acid (LAC), creatine kinase (CK) and creatine kinase (CKMB) were higher in obese before pregnancy group than those of normal before pregnancy group. Correlation analysis showed that maternal low density lipoprotein cholesterol (LDL- C), total cholesterol (TC), three acyl glycerol (TG) and HbA1c were negatively correlated with neonatal Apgar score and pH, and which were positively correlated with neonatal LAC and CKMB. Both differences were significant (P＜0.05 or P＜0.01). Conclusion The dyslipidaemia in early onset preeclampsia in obesity patients before pregnancy is closely related with maternal and perinatal outcomes.

Key words: pre-eclampsia, obesity, perinatology, early-onset preeclampsia