孕妇血尿钙镁与骨代谢指标BGP和DPD的相关性临床研究

Analysis on the correlation between the levels of Ca^(2+) and Mg^(2+) and bone gla protein and deisoxypyridoxine hydrochloride in blood and urine in pregnant women

目的:研究孕妇妊娠期钙、镁及骨代谢指标骨钙素、尿脱氧吡啶酚的变化。方法:240例初孕妇按孕期分为早(16±1)周、中(26±1)周、晚(36±1)周3组,每组80例,60例健康未孕妇女作为对照组。测其空腹静脉血中的钙(Ca2+)、镁(Mg2+)、骨钙素(BGP),同时测其尿Ca2+、Mg2+及尿脱氧吡啶啉(DPD)、肌酐(Cr)。结果:孕妇血清钙浓度由孕早期的(1.840±0.39)mmol/L降至孕末期的(1.710±0.31)mmol/L,明显低于非孕妇(2.375±0.42)mmol/L,P<0.01;血清镁由孕早期的(0.818±0.095)mmol/L降至孕末期的(0.74±0.095)mmol/L,低于非孕妇(1.090±0.53)mmol/L,P<0.05;血清BGP由孕早期的(6.16±3.33)ng/L降至孕晚期的(3.93±2.57)ng/L,均明显低于非孕妇(7.24±4.04)ng/ml,P<0.01。尿Ca2+/Cr在妊娠过程中呈上升趋势,由孕早期的(0.51±0.23)上升至孕晚期的(0.70±0.32),高于非孕妇(0.19±0.13),P<0.05;尿DPD/Cr由孕早期的(17.59±5.65)升至孕晚期的(24.4±14.4),明显高于非孕妇(12.95±2.44),P<0.01。尿Ca2+、Mg2+与DPD正相关(r分别为0.617、0.648,P<0.01),血清Ca2+与DPD呈负相关(r=-0.226,P<0.05)。结论:孕妇体内处于低钙、低镁状态,骨吸收增加,骨骼钙负荷增加。正常膳食不能满足母体及胎儿生长发育的需要,补充维生素D、钙的同时应注意镁的摄取。

Objective： To explore the changes of Ca^2＋ , Mg^2＋ , bone gla protein （BGP） and deisoxypyridoxine hydrochloride（DPD） in blood and urine in pregnant women. Methods： 240 primigravida and 60 healthy non - gestational women were selected randomly, then 240 primigravida were divided into first trimester group [ （ 16 ± 1 ） weeks], mid trimester group [ （26 ± 1 ） weeks] and last trimester group [ （36 ± 1 ） weeks] on average. The levels of Ca^2＋ , Mg^2 ＋ , BGP in blood and Ca^2＋ , Mg^2＋ , DPD and creatinine （Cr） in urine were detected. Results： The levels of Ca^2＋ in blood in first trimester group and last trimester group were （ 1. 840 ±0. 39 ） mmol/L and （ 1.710 ± 0. 31 ） mmol/L, respectively, which were lower than that in non - gestational women [ （ 2. 375 ±0. 42 ） mmol/L, （ P 〈 0. 01 ） ] . The levels of Mg^2 ＋ in blood in first trimester group and last trimester group were （ 0. 818 ± 0. 095 ） mmol/L and （0. 74 ± 0. 095 ） mmol/L, respectively, which were lower than that in non - gestational women [ （ 1. 090 ± 0. 53 ） mmol/L, （ P 〈 0.05 ） ] . The levels of BGP in blood in first trimester group and last trimester group were （6. 16 ± 3.33） ng/L and （3.93 ± 2.75） ng/L, respectively, which were lower than that in nongestational women [ （7.24±4. 04） ng/ml, （P 〈 0. 01 ）] . The ratios of Ca^2＋/Cr in urine in first trimester group and last trimester group were （0. 51 ±0. 23） and （0. 70±0. 32） , respectively, which were higher than that in non - gestational women [ （0. 19 ±0. 13） , （ P 〈 0. 05 ） ] . The ratios of DPD/Cr in urine in first trimester group and last trimester group were （ 17. 59 ± 5.65 ） and （ 24. 4 ±14. 4 ） retool/L, respectively, which were higher than that in non - gestational women [ （ 12.95 ± 2. 44）, （ P 〈0. 01 ） ] . There was positive correlation between levels of Ca^2＋ , Mg^2＋ in urine and DPD （r =0. 617, 0. 648, P 〈0. 01 ）, while there was negative correlation between Ca^2＋ in blood and DPD （ r = - 0. 226, P 〈 0. 05 ） . Conclusion ： The levels of Ca^2＋ , Mg^2 ＋ in blood and urine are low, bone resorption and calcium load increase. It may be essential that supply of vitamin D and calcium as well as magnesium in normal pregnancy.