Gratacós E, Casals E, Sanllehy C, Cararach V, Alonso P L, Fortuny A
Departament d'Obstetrícia i Ginecologia, Hospital Clinic, Universitat de Barcelona, Spain.
Acta Obstet Gynecol Scand. 1996 Nov;75(10):896-901. doi: 10.3109/00016349609055024.
To evaluate the levels of serum lipids (cholesterol and triglycerides) in pregnant women with different types of hypertension, at the first, second and third trimesters of pregnancy.
Cholesterol and triglyceride levels at the first, second and third trimesters of gestation were recorded for 115 women with hypertension during pregnancy, and 115 healthy pregnant women matched for age and body mass index. Cases were classified as having mild gestational hypertension (25), severe gestational hypertension (15), mild preeclampsia (20), severe preeclampsia (20), chronic hypertension (20), and superimposed preeclampsia (15).
Cholesterol levels were not statistically different between cases and controls in any form of hypertension. At 20 and 34 weeks' gestation, triglyceride levels were significantly higher than controls in women with severe gestational hypertension, mild and severe preeclampsia, and superimposed preeclampsia, but not in mild gestational hypertension or chronic hypertension. The significant elevation in triglycerides was already present at 10 weeks in mild and severe preeclampsia.
The data suggest that the alterations in lipid metabolism observed in preeclampsia are already present at the first trimester of pregnancy. Women with severe gestational hypertension presented a pattern of triglycerides similar to that of preeclamptic women, but mild gestational hypertension resembled chronic hypertension in this respect. This supports the concept that, although in many cases gestational hypertension represents latent essential hypertension, some of these women, probably the most severe cases, present with true pregnancy-induced hypertension, or nonproteinuric preeclampsia.
评估不同类型高血压孕妇在妊娠第一、第二和第三孕期的血脂（胆固醇和甘油三酯）水平。
记录了115例妊娠期高血压妇女以及115例年龄和体重指数相匹配的健康孕妇在妊娠第一、第二和第三孕期的胆固醇和甘油三酯水平。病例分为轻度妊娠期高血压（25例）、重度妊娠期高血压（15例）、轻度子痫前期（20例）、重度子痫前期（20例）、慢性高血压（20例）和叠加子痫前期（15例）。
在任何形式的高血压中，病例组和对照组的胆固醇水平在统计学上无差异。在妊娠20周和34周时，重度妊娠期高血压、轻度和重度子痫前期以及叠加子痫前期妇女的甘油三酯水平显著高于对照组，但轻度妊娠期高血压或慢性高血压妇女则不然。轻度和重度子痫前期在妊娠10周时甘油三酯就已显著升高。
数据表明子痫前期观察到的脂质代谢改变在妊娠第一孕期就已存在。重度妊娠期高血压妇女的甘油三酯模式与子痫前期妇女相似，但轻度妊娠期高血压在这方面类似于慢性高血压。这支持了这样一种观点，即尽管在许多情况下妊娠期高血压代表潜在的原发性高血压，但其中一些妇女，可能是最严重的病例，表现为真正的妊娠诱导性高血压或非蛋白尿性子痫前期。
