妊娠期异常高脂血症2例报告并文献复习

doi:10.6040/j.issn.1671-7554.0.2021.0104

摘要/Abstract

摘要： 目的分析2例妊娠期异常高脂血症病例并复习相关文献,为临床工作处理类似情况提供参考。方法回顾了山东大学齐鲁医院产科收治的2例妊娠期异常高脂血症病例的临床资料。结果此2例病例中,1例合并糖尿病,并发高胆汁酸血症,因胎盘早剥于孕33⁺¹周行剖宫产术;另1例合并妊娠期糖尿病(GDM),因巨大儿于40⁺¹周行剖宫产术。2例新生儿出生后Apgar评分均正常,且无高脂血症。结论对于异常高脂血症的孕妇,需要密切关注其血脂、血糖、肝肾功能等指标及有无胰腺炎、胎盘早剥等发生。高脂血症本身并非剖宫产的指征,但若出现了胎盘早剥等情况,则需行剖宫产术终止妊娠。

关键词: 高脂血症, 妊娠期血脂异常, 高胆汁酸, 肝内胆汁淤积症, 妊娠

Abstract: Objective To analyze 2 cases of abnormal hyperlipidemia during pregnancy and review the related literature, so as to provide reference for clinical work when dealing with similar situations. Methods Clinical data of 2 cases of abnormal hyperlipidemia during pregnancy admitted to the Department of Obstetrics, Qilu Hospital of Shandong University was reviewed. Results One case was complicated with diabetes and hyperbileacidemia, and had a cesarean section at 33⁺¹ weeks of pregnancy due to placental abruption. Another case was combined with gestational diabetes mellitus(GDM), and a cesarean section was performed at 40⁺¹ weeks for a giant baby. The Apgar scores of the two newborns were normal after birth, and no hyperlipidemia occured. Conclusion Pregnant women with abnormal hyperlipidemia should be paid close attention to their blood lipids, blood sugar, liver and kidney function and other indicators, as well as the occurrence of pancreatitis and placental abruption. Hyperlipidemia itself is not an indication for cesarean section, but if placental abruption occurs, cesarean section is required to terminate the pregnancy.

Key words: Hyperlipidemia, Dyslipidemia during pregnancy, High bile acid, Intrahepatic cholestasis, Pregnancy

中图分类号:

R714

龙宇晗,罗霞,姜洁. 妊娠期异常高脂血症2例报告并文献复习[J]. 山东大学学报 (医学版), 2021, 59(3): 103-106.

LONG Yuhan, LUO Xia, JIANG Jie. Abnormal hyperlipidemia during pregnancy: a report of 2 cases and literature review[J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 103-106.

参考文献

[1] 胡小月,霍琰.脂代谢与妊娠期并发症研究新进展[J].中国计划生育和妇产科,2018, 10(1): 15-18.
[2] Mudd LM, Holzman CB, Evans RW. Maternal mid-pregnancy lipids and birthweight[J]. Acta Obstet Gynecol Scand, 2015, 94(8): 852-860.
[3] 孟彤,刘亚非,孟文颖.应用临床分析结果确定妊娠期正常血脂参考值范围[J].中国妇幼保健,2016, 31(21): 4408-4411. MENG Tong, LIU Yafei, MENG Wenying. Determination of normal reference value ranges of serum lipids during pregnancy by applying clinical analysis results[J]. Maternal and Child Health Care of China, 2016, 31(21): 4408-4411.
[4] 宋云端,吕涛,常东,等.3040例妊娠期孕妇血脂检验结果的回顾性分析[J].国际检验医学杂志,2017, 38(7): 997-999.
[5] 杨怡珂,丁新.妊娠期血脂的相关研究进展[J].医学综述,2017, 23(15): 3002-3007. YANG Yike, DING Xin. Research process of blood lipids in pregnancy[J]. Medical Recaptulate, 2017, 23(15): 3002-3007.
[6] Ustün Y, Engin-Ustün Y, Dökmeci F, et al. Serum concentrations of lipids and apolipoproteins in normal and hyperemetic pregnancies[J]. J Matern Fetal Neonatal Med, 2004, 15(5): 287-290.
[7] 吴菲菲,胡玉利,吴元赭.妊娠中期血脂异常与妊娠结局的相关性研究[J].东南国防医药, 2020, 22(3): 272-276. WU Feifei, HU Yuli, WU Yuanzhe. Study on the relationship between hyperlipidemia of in the second trimester of pregnancy and pregnancy outcome [J]. Military Medical Journal of Southeast China, 2020, 22(3): 272-276.
[8] Simmons SC, Dorn DP, Walton CM, et al. Hypertriglyceridemia in pregnancy[J]. Transfusion, 2017, 57(12): 2824-2825.
[9] Bao W, Dar S, Zhu Y, et al. Plasma concentrations of lipids during pregnancy and the risk of gestational diabetes mellitus: a longitudinal study [J]. J Diabetes, 2018, 10(6): 487-495.
[10] Smedts HP, van Uitert EM, Valkenburg O, et al. A derangement of the maternal lipid profile is associated with an elevated risk of congenital heart disease in the offspring[J]. Nutr Metab Cardiovasc Dis, 2012, 22(6): 477-485.
[11] 杨海艳,胡敏,陈江鸿.妊娠期肝内胆汁淤积症孕妇的母儿结局及其影响因素分析[J].中华妇产科杂志,2016, 51(7): 535-537.
[12] 汤人夷,胡群凤,彭莉晴.妊娠期肝内胆汁淤积症患者血脂、肝功能和雌激素水平的变化及临床意义[J].实用肝脏病杂志,2019, 22(6): 860-863. TANG Renyi, HU Qunfeng, PENG Liqing. Changes of serum lipids, liver function tests and estrogen levels in patients with intrahepatic cholestasis of pregnancy and its clinical significance[J]. Journal of Practical Hepatology, 2019, 22(6): 860-863.
[13] Sharma R, Long A, Gilmer JF. Advances in bile acid medicinal chemistry[J]. Curr Med Chem, 2011, 18(26): 4029-4052.
[14] Dann AT, Kenyon AP, Wierzbicki AS, et al. Plasma lipid profiles of women with intrahepatic cholestasis of pregnancy[J]. Obstet Gynecol, 2006, 107(1): 106-114.
[15] Floreani A, Caroli D, Lazzari R, et al. Intrahepatic cholestasis of pregnancy: new insights into its pathogenesis [J]. J Matern Fetal Neonatal Med, 2013, 26(14): 1410-1415.
[16] Hao ZM, Ye YF, Zhang YK, et al. Lipoprotein lipase and lipid profiles in plasma and placenta from normal pregnancies compared with patients with intrahepatic cholestasis of pregnancy[J]. Eur J Obstet Gynecol Reprod Biol, 2016, 203: 279-285. doi: 10.1016/j.ejogrb.2016.06.019.
[17] Jin WY, Lin SL, Hou RL, et al. Associations between maternal lipid profile and pregnancy complications and perinatal out-comes: apopulation-based study from China [J]. BMC Pregnancy Childbirth, 2016, 16: 60. doi: 10.1186/s12884-016-0852-9.
[18] 郝志敏,刘忠,杨素芬.妊娠期肝内胆汁淤积症患者血脂水平变化及临床意义[J].中国妇产科临床杂志,2016, 17(4): 359-361.

相关文章 15

[1]	艾星子·艾里,郭铮宇,张晓霏. 子宫腺肌病高强度聚焦超声消融治疗研究进展[J]. 山东大学学报 (医学版), 2022, 60(7): 36-42.
[2]	袁孟绮,霍凤蕾,任会萍,郭秋爽,蓝菁. Sdccag3通过Wnt通路对高脂血症大鼠种植体骨结合的影响[J]. 山东大学学报 (医学版), 2022, 60(7): 66-73.
[3]	曹丹凤,刘宗花,王君芝,张国翔. 女性儿童期家庭功能障碍对成年后妊娠期抑郁症状的独立和累积作用[J]. 山东大学学报 (医学版), 2022, 60(6): 97-101.
[4]	吴日超,刘红,王泽,高姗姗,李秀芳,石玉华. 40岁及以上女性行体外受精-胚胎移植助孕的妊娠结局分析[J]. 山东大学学报 (医学版), 2022, 60(6): 35-39.
[5]	李燕,刘静,李娟,杨秋红. 50例孕产妇血流感染临床特征及胎盘病理分析[J]. 山东大学学报 (医学版), 2022, 60(1): 48-54.
[6]	张建平,罗莺儿. 抗凝药物在反复不良妊娠治疗中的应用进展[J]. 山东大学学报 (医学版), 2021, 59(8): 14-19.
[7]	陈伟,郭情情,徐金,方园,孙梅,盛燕. 自然周期联合黄体期卵巢刺激助孕和双重刺激助孕效果的对比分析[J]. 山东大学学报 (医学版), 2021, 59(8): 61-66.
[8]	邬晓琳,李萍. 激动剂长方案下促性腺激素使用时长对体外受精胚胎移植妊娠结局的影响[J]. 山东大学学报 (医学版), 2021, 59(7): 32-37.
[9]	萧阳,陶宇,王方怡,梁俞秀,张晋,季晓康,王志萍. 山东省部分地区PM_2.5和PM₁₀暴露与妊娠期糖尿病的关联性分析[J]. 山东大学学报 (医学版), 2021, 59(12): 101-109.
[10]	霍素霞,刘薇,王鑫. 86例Ⅲ型瘢痕妊娠诊治体会[J]. 山东大学学报 (医学版), 2021, 59(1): 40-44.
[11]	贾明旺,廖广园,熊明媚,徐文婷,王银玲,王懿春. 84例妊娠合并肺高血压患者预后的临床分析[J]. 山东大学学报 (医学版), 2021, 59(1): 34-39.
[12]	陈擎仪,张烜,王娟,孙继伟,曹丹凤, 曹枫林. 妊娠期女性自杀意念的危险因素及其累积效应[J]. 山东大学学报 (医学版), 2021, 59(1): 91-94.
[13]	师少乐,宫伟雁. 妊娠相关噬血细胞性淋巴组织细胞增多症1例[J]. 山东大学学报 (医学版), 2020, 58(6): 121-124.
[14]	张秀清,张敬,蒋琪,李晨,刘畅,李瑞静,冯惠娟,耿玲. 腔内理疗对89例薄型子宫内膜冻融胚胎移植患者妊娠结局的影响[J]. 山东大学学报 (医学版), 2020, 58(5): 62-68.
[15]	高任远,张敬,刘方方,李瑞静,张秀清,秦莹莹. 抗苗勒管激素与女性自然妊娠能力的关联分析[J]. 山东大学学报 (医学版), 2020, 58(4): 100-104.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed