妊娠期肾病综合征患者脂代谢特点及对母婴结局的影响

摘要

[ Abstract]Objective:To investigate the characteristics of lipid metabolism in pregnant women with nephrotic syndrome( NSP)and its effect on maternal and neonatal outcomes. Methods:154 cases of severe preeclampsia,according to whether complicated with NSP were divided into NSP group( n=38)and non NSP group(n=116);. The systolic blood pressure(SBP)and diastolic blood pressure ( DBP),the onset time and the time of pregnancy termination were compared between the two groups, and complications of placental abruption,ascites formation,eclampsia,renal damage and postpartum hemorrhage were compared;early morning fasting blood glucose,serum total cholesterol( TC),tri-glyceride( TG),serum creatinine( Cr),urea nitrogen( BUN),high density lipoprotein( HDL),low density lipoprotein(LDL),apolipoprotein A1(apoA1),apolipoprotein protein B(apoB)level were determined by automatic biochemical analyzer after admission;24 h urine were collected,and 24 h u-rine protein was detected by paper strip method. Results:In NSP group,the time of termination of pregnancy,the onset time of hypertension were significantly earlier than non NSP group,the difference was statistically significant(P﹤0. 05);In NSP group,24 h urine protein,serum TC,TG,apoB,Cr,BUN levels were higher than those in non NSP group,apoA1 and HDL were lower than those in non NSP group( P ﹤0 . 05 );The incidence of pregnancy complications in NSP group was significantly higher than that in non NSP group,and the incidence of perinatal complications in NSP group was higher than that in non NSP group( P ﹤0 . 05 ). Conclusion:The pregnancy outcome and perinatal complications in pregnant women with NSP may be associated with severe hypoproteinemia and lipid metabolic disorder during pregnancy.%目的：探讨妊娠期肾病综合征（ NSP）的脂代谢特点及NSP对母婴结局的影响。方法：154例重度子痫前期患者，根据是否发生NSP分为NSP组（ n＝38）与非NSP组（ n＝116）；比较两组孕妇入院时的收缩压（ SBP）和舒张压（ DBP）、发病时间、终止妊娠时间，比较胎盘早剥、腹水形成、子痫、肾功能损害及产后出血并发症，比较胎儿生长受限、胎儿宫内窘迫、早产儿、低体重儿及新生儿窒息等围生儿并发症，采用全自动生化分析仪测定入院后孕妇清晨的空腹血糖、血清总胆固醇（ TC）、甘油三酯（ TG）、血肌酐（ Cr）、尿素氮（ BUN）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白A1（apoA1）、载脂蛋白B（apoB）水平；收集24 h尿液，采用试纸法检测24 h尿蛋白。结果：NSP组孕妇的终止妊娠时间、高血压的发病时间均早于非NSP组（ P﹤0.05，）；NSP组孕妇24 h尿蛋白、血清TC、TG、LDL、apoB、Cr、BUN水平均高于非NSP组，apoA1、HDL低于非NSP组（ P﹤0.05）；NSP组妊娠并发症的发生率明显高于非NSP组，NSP组围生儿并发症的发生率也高于非NSP组（ P﹤0.05）。结论：NSP孕妇的妊娠结局及围生儿并发症可能与孕妇妊娠期间严重的低蛋白血症和脂质代谢紊乱有关。