中国实用儿科杂志

中国实用儿科杂志

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妊娠期血脂紊乱与胎儿先天性心脏病发病关系探讨

  

  1. 中山大学附属第一医院心血管儿科，广东  广州  510080
  • 出版日期:2016-08-06 发布日期:2016-08-02

Analysis of the relationship between pregnancy dyslipidemia and fetal congenital heart disease

  1. Department of Pediatric Cardiology， First Affiliated Hospital of SUN Yat-sen University， Guangzhou  510080， China
  • Online:2016-08-06 Published:2016-08-02

摘要：

目的    探讨妊娠期血脂水平与胎儿先天性心脏病之间的关系。方法    收集2013年3月至2014年6月于中山大学附属第一医院产检的孕周为24～28周的孕母54例， 其中18例存在胎儿先天性心脏病， 为病例组， 余36例为正常对照组。病例组与对照组孕母的年龄分别为（29.06±3.11）岁、（29.03±3.90）岁，主要检测指标包括总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、载脂蛋白以及同型半胱氨酸。结果    病例组孕母低密度脂蛋白胆固醇（4.15 mmol/L vs. 3.45 mmol/L，P＜0.05）及载脂蛋白B（2.23 g/L vs. 1.78 g/L，P＜0.05）水平较对照组明显升高。相关分析提示低密度脂蛋白胆固醇（r＝0.32，P＝0.017）、载脂蛋白B（r＝0.33，P＝0.016）及同型半胱氨酸（r＝0.34，P＝0.011）与胎儿患先天性心脏病相关。结论    病例组血清低密度脂蛋白胆固醇和载脂蛋白B水平较对照组明显升高。妊娠期血脂代谢异常可能会导致胎儿先天性心脏病的风险增加。

关键词: 先天性心脏病, 妊娠期, 载脂蛋白, 胆固醇, 危险因素

Abstract:

Objective   To investigate the relationship between the presence of dyslipidemia in pregnant females and the risk of congenital heart defects（CHD）. Methods   A total of 54 pregnant females at 24 to 28 weeks（w） of gestation admitted between March 2013 and June 2014 in Department of Pediatric Cardiology，First Affiliated Hospital of SUN Yat-sen University were enrolled in the study . The case group included 18 females who had a fetus with cardiac defects，and each case was matched with 2 controls with no pregnancy complications. The mean ages were 29.06（SD=3.11） years and 29.03（SD=3.9） years in the case and control groups，respectively. The main outcome measurements were total cholesterol（TC），triglycerides（TG），low-density lipoprotein cholesterol（LDL-c），high-density lipoprotein cholesterol（HDL-c），apolipoprotein and homocysteine. Results   Patients in the case group had a significantly higher mean LDL-c（4.15 mmol/L vs. 3.45 mmol/L） and apolipoprotein B （2.23 g/L vs. 1.78 g/L）（all P＜0.05） than those in the control group. Correlation analysis indicated that LDL-C（r=0.32，P=0.017），apolipoprotein B（r=0.33，P=0.016） and homocysteine（r=0.34，P=0.011） were associated with fetal congenital heart disease.Conclusion    Serum LDL-cholesterol and apolipoprotein B levels in the case group are significantly higher than those in the control group. Pregnancy dyslipidemia may be associated with a higher incidence rate of CHD.

Key words: congenital heart defects, pregnancy, apolipoproteins, cholesterol, risk factors