杨萍?何霞

[摘要] 目的 探讨早发型重度子痫前期（EOSP）患者血清高密度脂蛋白（HDL）和尿酸（UA）水平的变化及其与围产儿预后的关系。 方法 选择48例EOSP患者作为观察组，另选择同期在我院行产前检查的健康孕妇41例作为对照组。分别采血检测HDL、UA、尿素氮（BUN）和肌酐（Scr）水平，并观察两组围产儿的预后。 结果 观察组血清HDL、UA、BUN和Scr水平均显著高于对照组（P<0.01）。观察组的新生儿体重明显低于对照组（P<0.01），而早产、胎儿窘迫的发生率及围产儿死亡率则明显高于对照组（P<0.05）。 结论 EOSP患者血清HDL、UA水平升高与EOSP的发病及围产儿的不良预后有关。

[关键词] 早发型重度子痫前期；高密度脂蛋白；尿酸；围产儿

[中图分类号] R714.24 [文献标识码] A [文章编号] 2095-0616（2017）14-59-03

Changes of serum high density lipoprotein and uric acid levels in patients with early onset severe preeclampsia and its clinical significance

YANG Ping HE Xia

Department of Obstetrics and Gynecology， Baiyun District Hospital of traditional Chinese Medicine， Guangdong， Guangzhou 510470， China

[Abstract] Objective To explore the changes of serum high density lipoprotein and uric acid levels in patients with early onset severe preeclampsia and its relation with perinatal prognosis. Methods 48 patients with EOSP were selected as observation group. In addition， 41 healthy pregnant women who underwent prenatal care in our hospital during the same period were selected as control group. HDL， UA， urea nitrogen （BUN） and creatinine （Scr） levels were measured by blood sampling. Prognosis of two groups of perinatal children was observed. Results The serum levels of HDL， UA， BUN and Scr in the observation group were significantly higher than those in the control group （P<0.01）. The neonatal weight of the observation group was lower than that of the control group （P<0.01）. The incidence of premature birth， fetal distress and perinatal mortality were higher than those in the control group （P<0.05）. Conclusion Elevated levels of serum HDL and EOSP in patients with UA are associated with the incidence of EOSP and the adverse prognosis of perinatal infants.

[Key words] Early onset severe pre eclampsia； High-density lipoprotein； Uric acid； Perinatal

妊娠期高血壓疾病（HDCP）是妊娠期特发疾病，子痫前期为其常见类型，是导致孕产妇及围产儿死亡的原因之一。早发型重度子痫前期（early onset severe preeclampsia，EOSP）是指在34孕周前发病的重度子痫前期，具有发病早、进展快、复发风险高、易出现多器官功能障碍等特点，受到临床医生的广泛关注。高密度脂蛋白（HDL）为一复杂的多功能蛋白复合体，已成为参与免疫反应的主要蛋白[1]。近年来的研究表明[2]，HDL 与EOSP的发病有着密切关系。尿酸（UA）为嘌呤代谢的终产物，其与子痫前期的关系也日益受到重视[3]。本研究对EOSP患者联合检测血清HDL和UA，并观察围产

儿的结局，探讨血清HDL和UA水平与围产儿预后的关系，为临床诊治提供理论依据。

1 资料与方法

1.1 研究对象

选择2014年1月～2017年2月间白云区中医医院妇产科收治的48例EOSP患者作为观察组，均符合重度子痫前期的临床诊断标准[4]。平均年龄（27.9±4.8）岁，平均孕周（26.7 ±4.6）周；均为自然受孕，其中初次妊娠34例，第2次妊娠14例，有EOSP既往史者10例。另选择同期在我院行产前检查的健康孕妇41例作为对照组，平均（27.3±4.5）岁，平均孕周（25.8±4.4）周，也均为自然受孕，其中初次妊娠31例，第2次妊娠10例。……