Özgür ÖZTEKİN, Deniz CAN, Özer ÖZTEKİN, Zehra ADIBELLİ, Yusuf ABALI, Şivekar TINAR

Doppler bulguları eşliğinde normal ve hipertansif gebelerde plazma lipit profillerinin karşılaştırılması

Bugün için preeklampsinin etiyolojisi hala kesin olarak bilinmemekle birlikte önemli bir maternal ve perinatal mortalité nedenidir. Bu çalışmamızda normal ve hipertansif gebelerde Doppler bulguları eşliğinde plazma lipid seviyelerini inceledik. Plazma lipit profili değişikliklerinin, pre-eklampsi etiyolojisinde rol oynayabileceğini göstermeyi amaçladık. Çalışmamızın sonucunda artmış trigliserid, VLDL, LDL değerlerinin pre-eklampsi riskini artırdığı sonucuna vardık. Eylül 2000 - Şubat 2001 tarihleri arasında SSK Ege Doğumevi ve Kadın Hastalıkları Hastanesi'ne başvuran normatansif, kronik hipertansif ve pre-eklamptik olan toplam 135 gebe çalışmamıza dahil edildi. Pre-eklamptik grup, doppler değerlerine göre, normal ve anormal olmak üzere iki gruba ayrıldı. Hastaların plazma lipit seviyeleri birbirleri ile karşılaştırdı. Tüm gebelikte hipertansif olan hastalarda, pre-eklamptiklerde daha fazla olmak üzere plazma trigliserid ve VLDL değerlerinin yükseldiği görüldü. Pre-eklamptik grupta Doppler bulgularının bozulması halinde ise HDL hariç tüm lipit seviyelerinin arttığı gözlendi. Kronik hipertansif hastalarla, doppler kan akımı normal değerlerde olan pre-eklamptik hastalar birbirine benzer serum lipit profillerine sahiptiler. Doppler değerleri normal olan pre-eklamptiklerle kronik hipertansif olan gebelerin benzer kan lipit profili değişiklikleri göstermeleri bu iki durumun benzer etiyolojilere sahip olabileceğini düşündürdü. Anormal doppler değerleri olan pre-eklamptiklerin kan lipit profillerinin bunlardan oldukça farklılık göstermesi, bu durumun ayrı bir etiyolojiye sahip olabileceği ihtimalini düşündürmekteydi. Plazma lipit profili değişiklikleri, pre-eklampsi patofizyolojisinin aydınlatılmasında rol oynayabilir ve risk altındaki gebelerin belirlenmesinde prediktif değer taşıyabilir.

Anahtar Kelimeler:

Hipertansiyon, Lipidler, Preeklampsi, Gebelik komplikasyonları, Ultrasonografi, doppler

The comparison of plasma lipid profiles of normal and hypertensive pregnances in association with doppler findings

Although etiology of pre-eclampsia is still not kown with certainity, it continues to be an important maternal and perinatal mortality cause. We investigated plasma lipid profiles of normal and hypertensive patients with the findings of Doppler ultrasonography. We aimed to show the possibility that changes in the lipid profile may play a role in the etiology of preeclampsia.A total of 135 pregnant women constituted of normotensive, chronic hypertensive and pre-eclamptic patients who admitted to Social Securities Ege Maternity Hospital during September 2000 - February 2001 were included in this study.Pre-eclamptic group was divided into two groups according to Doppler findings as normal and abnormal. Plasma lipid profiles of patients were compared among groups. All hypertensive patients especially pre-eclamptic ones had elevated levels of plasma triglycérides and VLDL. In pre-eclamptic group with abnormal Doppler findings all plasma lipid levels were elevated except for HDL. Chronic hypertensive patients and pre-eclamptic patients with normal Doppler findings had similar serum lipid profiles. Our finding of similar serum lipid profiles of chronic hypertensive patients with those of pre-eclamptic patients with normal Doppler findings leads us to think that these two conditions may have similar etiologies. Dissimilarity of the group of pre-eclamptic patients with abnormal Doppler findings arouses the possibility that this latter condition may have a different etiology. Changes InI plasma lipid profile may play a röle in clarifying pathophysiology of pre-eclampsia and have a predictive value in identifying the pregnancies under risk.

Keywords:

Hypertension, Lipids, Pre-Eclampsia, Pregnancy Complications, Ultrasonography, Doppler,

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