维生素A、E水平对子痫前期妊娠结局的影响
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摘要
目的探讨子痫前期孕妇不同维生素A、E水平对妊娠结局的影响。方法选取义乌市妇幼保健院妇产科自2017年3月—2018年3月间收治的子痫前期孕妇120例作为实验对象,依据其12～20周测定血清维生素A、E水平进行分组,维生素A、E均正常组30例(对照组),维生素A正常/E缺乏组30例(观察a组),维生素A缺乏/E正常组30例(观察b组),维生素A、E均异常组30例(观察组),对比4组孕妇早产率、引产率、死胎以及新生儿窒息情况。结果观察组孕妇早产率高于其他3组,引产/死胎率略高于观察a组、观察b组和对照组,观察组新生儿窒息率显著高于其他3组,差异具有统计学意义(均P<0.05);对照组患者产后出血6例(20.00%),观察a组11例(36.67%),观察b组13例(43.33%),观察组17例(56.67%),观察组患者出血量高于其他3组,观察a组和b组平均出血量与对照组比较差异无统计学意义,新生儿Apgar评分对照组高于其他3组。结论子痫前期患者血清维生素A、E缺乏会增加早产、新生儿窒息、产后出血等不良妊娠结局,因此针对PE患者需加强对孕期维生素A、E等水平的监测,适当补充以改善妊娠结局。
Objective To investigate the effects of different vitamin A and E levels on pregnancy outcome in pregnant women with preeclampsia. Methods One hundred and twenty cases of preeclampsia pregnant women admitted to our hospital from March 2017 to March 2018 in Ukrainian Maternal and Child Health Hospital Obstetrics and Gynecology were selected as experimental subjects. The serum vitamin A and E levels were determined according to their 12-20 weeks. Vitamin A and E were normal. 30 patients in the group(control group), 30 patients with normal vitamin/E deficiency(observation group a), 30 patients with vitamin A deficiency/E normal group(observed group b), and 30 patients with abnormal vitamin A and E(observation group), comparing the preterm birth rate, induction rate, stillbirth and neonatal asphyxia in 4 groups of pregnant women. Results The preterm birth rate of the observation group was higher than that of the other 3 groups. The induction/abortion rate was slightly higher than that of the observation group a, the observation group b and the control group(all P>0.05). The neonatal asphyxia rate in the observation group was significantly higher than that in the other 3 groups. The significance of learning(all P<0.05); 6 cases(20.00%) of postpartum hemorrhage in the control group, 11 cases(36.67%) in group a, 13 cases(43.33%) in group b, and 17 cases(56.67%) in observation group, observed The bleeding volume of the patients in the group was higher than that in the other 3 groups. The average blood loss of the group a and the b group was not significantly different from that of the control group. The neonatal Apgar score control group was higher than the other 3 groups. Conclusion Serum vitamin A and E levels in patients with preeclampsia have a greater impact on pregnancy outcomes. Pregnant women with normal vitamin levels have higher maternal and child safety.
Objective To investigate the effects of different vitamin A and E levels on pregnancy outcome in pregnant women with preeclampsia. Methods One hundred and twenty cases of preeclampsia pregnant women admitted to our hospital from March 2017 to March 2018 in Ukrainian Maternal and Child Health Hospital Obstetrics and Gynecology were selected as experimental subjects. The serum vitamin A and E levels were determined according to their 12-20 weeks. Vitamin A and E were normal. 30 patients in the group(control group), 30 patients with normal vitamin/E deficiency(observation group a), 30 patients with vitamin A deficiency/E normal group(observed group b), and 30 patients with abnormal vitamin A and E(observation group), comparing the preterm birth rate, induction rate, stillbirth and neonatal asphyxia in 4 groups of pregnant women. Results The preterm birth rate of the observation group was higher than that of the other 3 groups. The induction/abortion rate was slightly higher than that of the observation group a, the observation group b and the control group(all P>0.05). The neonatal asphyxia rate in the observation group was significantly higher than that in the other 3 groups. The significance of learning(all P<0.05); 6 cases(20.00%) of postpartum hemorrhage in the control group, 11 cases(36.67%) in group a, 13 cases(43.33%) in group b, and 17 cases(56.67%) in observation group, observed The bleeding volume of the patients in the group was higher than that in the other 3 groups. The average blood loss of the group a and the b group was not significantly different from that of the control group. The neonatal Apgar score control group was higher than the other 3 groups. Conclusion Serum vitamin A and E levels in patients with preeclampsia have a greater impact on pregnancy outcomes. Pregnant women with normal vitamin levels have higher maternal and child safety.
引文
[1] 何雪仪,王晨虹.子痫前期预测和预防的研究进展[J].国际妇产科学杂志,2014,41(2):171-174.
[2] 杨孜.子痫前期多因素发病及多机制发病通路之综合征再认识[J].中华医学杂志,2015,95(1):7-9.
[3] 罗欣,漆洪波.子痫前期发病机制分子生物学研究进展[J].中国实用妇科与产科杂志,2012,15(4):309-311.
[4] 林建华,乐怡平,庄旭.子痫前期相关指南对解痉及抗凝治疗的推荐及临床困惑[J].中华围产医学杂志,2015,18(6):414-417.
[5] 郝晋红,刘永红,刘文萃,等.联合检测妊娠早期血清维生素A、E水平对子痫前期的预测价值[J].中国妇幼保健,2017,32(24):6097-6100.
[6] 刘仁莲.综合计量法在产后出血量计算中的应用[J].护理学杂志,2004,19(10):20-21.
[7] 蔡林燕.妊娠期肝内胆汁淤积症总胆汁酸、雌三醇与新生儿Apgar评分的关系[J].中国妇幼保健,2016,31(5):932-934.
[8] 赵群,孔祥.子痫前期的病因学研究进展[J].医学研究杂志,2012,41(3):17-19.
[9] 闵爱萍,罗晓,冯欣,等.维生素A,E水平与子痫前期相关性研究[J].四川医学,2017,38(8 ):857-859.
[10] KHARB S,GULATI N,SINGH V,et al.Lipid peroxidation and vitamin E levels in preeclampsia[J].Gynecol Obstet Invest,1998,46(4):238-240.
[11] 赵志英,崔世红,李根霞,等.孕妇血清维生素A、E水平与子痫前期的相关性研究[J].中国医学创新,2018,11(8):207-208.
[12] 李军,韩玲,董力.子痫前期胎盘组织中维生素E的含量及与氧化应激损伤、细胞凋亡的相关性[J].海南医学院学报,2017,23(4):433-436.
[13] 孙艳秋,吴振兰,孙婧,等.不同妊娠期孕妇血清维生素A、维生素E、铁、钙含量分析[J].潍坊医学院学报,2016,38(6):433-435.
[14] 杨学芳,王爱蓉,陈庆昭.滋阴平肝法对子痫前期孕妇血脂水平及妊娠结局的影响[J].世界中医药,2018,13(5):91-94.
[15] 宋健,黄亚绢,陆继红.子痫前期孕妇的血清尿酸水平对母胎妊娠结局的预测作用[J].国际妇产科学杂志,2017,44(2):219-221.
[16] 索海燕,刘增佑,马春艺.高龄孕产妇血清铁蛋白和LDH水平与子痫前期和妊娠结局的关系[J].河北医药,2017,39(9):1327-1330.
[17] CARDOSO P M,SURVE S.The effect of vitamin E and vitamin C on the prevention of preeclampsia and newborn outcome:a case-control study[J].J Obstet Gynaecol India,2016,66(1):271-278.
[18] TANNETTA D S,SARGENT I L,LINTON E A,et al.Vitamins Cand E inhibit ap-optosis of cultured human term placentatrophoblast[J].Placenta,2008,29(8):680-690.
[19] RUMIRIS D,PURWOSUNU Y,WIBOWO N,et al.Lower rate ofpreeclampsia after antioxidant supplementation in pregnant women with low antioxi-dant status[J].Hypertens Pregnancy,2006,25(3):241-253.
[2] 杨孜.子痫前期多因素发病及多机制发病通路之综合征再认识[J].中华医学杂志,2015,95(1):7-9.
[3] 罗欣,漆洪波.子痫前期发病机制分子生物学研究进展[J].中国实用妇科与产科杂志,2012,15(4):309-311.
[4] 林建华,乐怡平,庄旭.子痫前期相关指南对解痉及抗凝治疗的推荐及临床困惑[J].中华围产医学杂志,2015,18(6):414-417.
[5] 郝晋红,刘永红,刘文萃,等.联合检测妊娠早期血清维生素A、E水平对子痫前期的预测价值[J].中国妇幼保健,2017,32(24):6097-6100.
[6] 刘仁莲.综合计量法在产后出血量计算中的应用[J].护理学杂志,2004,19(10):20-21.
[7] 蔡林燕.妊娠期肝内胆汁淤积症总胆汁酸、雌三醇与新生儿Apgar评分的关系[J].中国妇幼保健,2016,31(5):932-934.
[8] 赵群,孔祥.子痫前期的病因学研究进展[J].医学研究杂志,2012,41(3):17-19.
[9] 闵爱萍,罗晓,冯欣,等.维生素A,E水平与子痫前期相关性研究[J].四川医学,2017,38(8 ):857-859.
[10] KHARB S,GULATI N,SINGH V,et al.Lipid peroxidation and vitamin E levels in preeclampsia[J].Gynecol Obstet Invest,1998,46(4):238-240.
[11] 赵志英,崔世红,李根霞,等.孕妇血清维生素A、E水平与子痫前期的相关性研究[J].中国医学创新,2018,11(8):207-208.
[12] 李军,韩玲,董力.子痫前期胎盘组织中维生素E的含量及与氧化应激损伤、细胞凋亡的相关性[J].海南医学院学报,2017,23(4):433-436.
[13] 孙艳秋,吴振兰,孙婧,等.不同妊娠期孕妇血清维生素A、维生素E、铁、钙含量分析[J].潍坊医学院学报,2016,38(6):433-435.
[14] 杨学芳,王爱蓉,陈庆昭.滋阴平肝法对子痫前期孕妇血脂水平及妊娠结局的影响[J].世界中医药,2018,13(5):91-94.
[15] 宋健,黄亚绢,陆继红.子痫前期孕妇的血清尿酸水平对母胎妊娠结局的预测作用[J].国际妇产科学杂志,2017,44(2):219-221.
[16] 索海燕,刘增佑,马春艺.高龄孕产妇血清铁蛋白和LDH水平与子痫前期和妊娠结局的关系[J].河北医药,2017,39(9):1327-1330.
[17] CARDOSO P M,SURVE S.The effect of vitamin E and vitamin C on the prevention of preeclampsia and newborn outcome:a case-control study[J].J Obstet Gynaecol India,2016,66(1):271-278.
[18] TANNETTA D S,SARGENT I L,LINTON E A,et al.Vitamins Cand E inhibit ap-optosis of cultured human term placentatrophoblast[J].Placenta,2008,29(8):680-690.
[19] RUMIRIS D,PURWOSUNU Y,WIBOWO N,et al.Lower rate ofpreeclampsia after antioxidant supplementation in pregnant women with low antioxi-dant status[J].Hypertens Pregnancy,2006,25(3):241-253.