血清叶酸、同型半胱氨酸与妊娠期高血压疾病相关性研究
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摘要
回顾性分析住院治疗的妊娠期高血压疾病患者215例(观察组)和同期正常妊娠孕妇166例(对照组)的血清叶酸、同型半胱氨酸(HCY)的水平,分析血清叶酸、HCY与妊娠高血压疾病的关系;采用问卷方式调查两组孕妇孕期叶酸的补充情况,观察规范化补充叶酸(观察组1、对照组1)和未规范化补充叶酸(观察组2、对照组2)对血清叶酸、HCY水平的影响。结果显示观察组中血清叶酸低于对照组(P<0.05);观察组血清HCY水平高于对照组(P<0.05);两组血清HCY水平与血清叶酸水平(观察组r=-0.389,P<0.05,对照组r=-0.356,P<0.05)均呈负相关;观察组规范化补充叶酸的比例(19.53%)低于对照组(66.27%),差异有统计学意义(P<0.05);观察组规范化补充叶酸血清叶酸高于未规范化补充组(P<0.05),血清HCY低于未规范化补充组(P<0.05)。HCY升高在妊娠期高血压疾病发病中起重要作用,孕期规范化补充叶酸可降低妊娠期高血压疾病的发生。
This case-control study was conducted on 215 pregnant women with hypertensive disorders during pregnancy and 166 healthy pregnant women of the same gestational age who served as controls,observing the levels of serumfolic acid and homocysteine( HCY) in two groups,to investigate the relationship between serum folic acid,HCY and hypertensive disorder complicating pregnancy; Using questionnaires to investigate the supplementation of folic acid in pregnant women of two groups and observe the effects of standardized folic acid supplementation( casecontrol group 1,control group 1) and lack of standardized folic acid supplementation( case-control group 2,control group 2) on serum folic acid and HCY. The results showed that in case-control,serum folic acid was lower than that of the control group( P < 0. 05),the serum HCY was higher than that of the control group( P < 0. 05). The serum levels of homocysteine and serum folic acid were negatively correlated in both groups( r =-0. 389,P <0. 05,r =-0. 356,P < 0. 05). The proportion of standardized folic acid supplementation in the observation group( 19. 53%) was lower than that in the control group( 66. 27%),and the difference was statistically significant( P< 0. 05); case-control group 1 serum folic acid was higher than that of case-control group 2( P < 0. 05),the serum HCY was lower than that of case-control group 2( P < 0. 05). HCY plays an important role in the pathogenesis of hypertensive disorder complicating pregnancy. Regularization of folic acid supplementation during pregnancy can reduce the occurrence of hypertensive disorder complicating pregnancy.
This case-control study was conducted on 215 pregnant women with hypertensive disorders during pregnancy and 166 healthy pregnant women of the same gestational age who served as controls,observing the levels of serumfolic acid and homocysteine( HCY) in two groups,to investigate the relationship between serum folic acid,HCY and hypertensive disorder complicating pregnancy; Using questionnaires to investigate the supplementation of folic acid in pregnant women of two groups and observe the effects of standardized folic acid supplementation( casecontrol group 1,control group 1) and lack of standardized folic acid supplementation( case-control group 2,control group 2) on serum folic acid and HCY. The results showed that in case-control,serum folic acid was lower than that of the control group( P < 0. 05),the serum HCY was higher than that of the control group( P < 0. 05). The serum levels of homocysteine and serum folic acid were negatively correlated in both groups( r =-0. 389,P <0. 05,r =-0. 356,P < 0. 05). The proportion of standardized folic acid supplementation in the observation group( 19. 53%) was lower than that in the control group( 66. 27%),and the difference was statistically significant( P< 0. 05); case-control group 1 serum folic acid was higher than that of case-control group 2( P < 0. 05),the serum HCY was lower than that of case-control group 2( P < 0. 05). HCY plays an important role in the pathogenesis of hypertensive disorder complicating pregnancy. Regularization of folic acid supplementation during pregnancy can reduce the occurrence of hypertensive disorder complicating pregnancy.
引文
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[4]魏海青,郭燕,胡殿珍,等.基因检测叶酸利用能力的个体差异性临床观察[J].河北医药,2015,37(14):2133-5.
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[7]张军.血清学指标检测在临床妊娠高血压综合征诊断中的意义[J].检验医学与临床,2013,10(10):1247-8.
[8]程丝,冯娟,王宪.高同型半胱氨酸血症治疗研究进展[J].生理科学进展,2011,42(5):329-34.
[9]Shahbazian N,Jafari R M,Haghnia S.The evaluation of serum homocysteine,folic acid,and vitamin B12 in patients complicated with preeclampsia[J].Electro Physician,2016,8(10):3057-61.
[10]Vaughn J D,Bailey L B,Shelnutt K P,et al.Methionine synthase reductase 66A->G polymorphism is associated with increased plasma homocysteine concentration when combined with the homozygous methylenetetrahydrofolate reductase677C->T variant[J].J Nutr,2004,134(11):2985-90.
[11]何燕霞,巩姣梅,沈勇,等.河南省育龄女性叶酸利用能力现状研究[J].实用检验医师杂志,2012,4(1):6-10.
[2]苟文丽,薛艳.妊娠期高血压疾病国际指南与中国实践[J].中国实用妇科与产科杂志,2017,33(6):559-63.
[3]姚丽梅.高同型半胱氨酸血症和叶酸对心脑血管疾病的影响[J].内科,2012,7(4):384-7.
[4]魏海青,郭燕,胡殿珍,等.基因检测叶酸利用能力的个体差异性临床观察[J].河北医药,2015,37(14):2133-5.
[5]Laskowska M,Laskowska K,Oleszczuk J.Differences in the association between maternal serum homocysteine and ADMA levels in women with pregnancies complicated by preeclampsia and/or intrauterine growth restriction[J].Hypertens Pregnancy,2013,32(1):83-93.
[6]李建平,卢新政,霍勇,等.H型高血压诊断与治疗专家共识[J].中国实用内科杂志,2016,8(4):23-8.
[7]张军.血清学指标检测在临床妊娠高血压综合征诊断中的意义[J].检验医学与临床,2013,10(10):1247-8.
[8]程丝,冯娟,王宪.高同型半胱氨酸血症治疗研究进展[J].生理科学进展,2011,42(5):329-34.
[9]Shahbazian N,Jafari R M,Haghnia S.The evaluation of serum homocysteine,folic acid,and vitamin B12 in patients complicated with preeclampsia[J].Electro Physician,2016,8(10):3057-61.
[10]Vaughn J D,Bailey L B,Shelnutt K P,et al.Methionine synthase reductase 66A->G polymorphism is associated with increased plasma homocysteine concentration when combined with the homozygous methylenetetrahydrofolate reductase677C->T variant[J].J Nutr,2004,134(11):2985-90.
[11]何燕霞,巩姣梅,沈勇,等.河南省育龄女性叶酸利用能力现状研究[J].实用检验医师杂志,2012,4(1):6-10.