妊娠高血压综合征对妇女远期血清高敏C反应蛋白浓度的影响

Long term impact of pregnancy-induced hypertention on high sensitivity C-reactive protein

  • 摘要: 目的探讨妊娠高血压综合征(PIH)病史对妇女远期血清高敏C反应蛋白(hsCRP)浓度的影响。方法选择1976年10月至2006年6月在开滦医疗集团各医院分娩且参加2006年7月至2007年10月健康体检的PIH妇女512例,按照分娩年龄相仿(±2岁)选取同期分娩的非PIH妇女512例作为对照组。比较两组在健康体检时的hsCRP水平的差异。结果随访时间为(13.7±6.6)年。与对照组比较,PIH组妇女产前腹围、产前收缩压及舒张压均较高,而孕周、新生儿体质量较低(P<0.05)。健康体检时,PIH组年龄、随访时间、收缩压、舒张压、腰围、体质量指数(BMI)、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、三酰甘油、hsCRP均高于对照组,而高密度脂蛋白胆固醇(HDL-C)则低于对照组(P<0.05)。其中PIH组与对照组hsCRP浓度分别为0.70(0.23~2.06)、0.60(0.20~1.28)mg/L(P<0.01)。PIH组高血压、心肌梗死、脑梗死患病率均高于对照组(P<0.01)。PIH组中hsCRP>3mg/L的研究对象所占比例为15.0%,高于对照组的9.4%,而hsCRP<1mg/L的研究对象在PIH组中所占比例为58.4%,低于对照组的68.2%(P<0.01)。随着hsCRP浓度的递增,高血压、心肌梗死、脑梗死的患病率均呈现逐渐增高的趋势。多因素Logistic回归分析结果显示,在校正了孕周和产前腹围后,PIH组发生远期高hsCRP的风险是对照组的2.46倍(95%CI1.43~4.24,P<0.01)。进一步校正体检时的年龄、随访时间、收缩压、腰围、BMI、血脂和空腹血糖后,PIH组发生远期高hsCRP的风险是对照组的1.86倍(95%CI 1.18~2.92,P<0.01)。结论PIH是妇女远期高hsCRP的独立危险因素。

     

    Abstract: Objective To investigate the long term impact of pregnancy-induced hypertension(PIH)on high sensitiviy C-reactive protein(hsCRP). Methods Five hundred and twelve cases of women with PIH gave birth during October 1976to June 2006and participated the physical examination between July 2006and October 2007at Kailuan medical group were identified,and matched with 512control subjects according to the same birth-giving period(±2years old). The hsCRP levels were determined in the two groups at the time of the physical examination. Results The follow-up time was(13.7±6.6)years. The abdominal circumference,systolic blood pressure,diastolic blood pressure before delivery were significantly higher,while gestational weeks and weight of newborn were significantly lower in PIH group than those in control group(P<0.05). Levels of age,follow-up time,systolic blood pressure,diastolic blood pressure,waist circumference,body mass index,total cholesterol,low density lipoprotein cholesterin,triglyceride,hsCRP during the examination were significantly higher,while high density lipoprotein cholesterin was significantly lower in PIH group than control group(P<0.05). The concentration of hsCRP in PIH group and control group were 0.70(0.23-2.06)mg/L,0.60(0.20-1.28)mg/L(P<0.01),respectively.The prevalence of hypertension,myocardial infarction and cerebral infarction were significantly higher in PIH group than those in control group(P<0.01).The proportion of cases of hsCRP>3mg/L in PIH group was higher than in control group(15.0%vs 9.4%),while the proportion of cases of hsCRP<1mg/L in PIH group was less than in control group(58.4%vs 68.2%),P<0.01. With the increasing of hsCRP,the prevalence of hypertension,myocardial infarction and cerebral infarction shows the tendency of gradually increased. According to multivariate Logistic regression analysis,after adjustment for the abdominal circumference before delivery and gestational weeks,the risk of high hsCRP in PIH group was 2.46times of control group(95%CI1.43-4.24,P<0.01). After further adjustment for age,follow-up time,systolic blood pressure,waist circumference,body mass index,total cholesterol,triglyceride,low density lipoprotein cholesterin,high density lipoprotein cholesterin and fasting blood glucose,the risk of high hsCRP in PIH group was 1.86times of control group(95% CI 1.18-2.92,P<0.01).Conclusion PIH is an independent risk factor for long term high hsCRP.

     

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