孕妇血浆同型半胱氨酸水平与早产的关系

Relationship between plasma homocysteine level in pregnant women and premature delivery

目的：研究孕妇血浆同型半胱氨酸水平与早产的关系。方法：采用病例对照研究，用高效液相色谱荧光检测法（HPLC—FD）检测60例孕28～34周早产孕妇（病例组）和30例非早产于孕31～34周采血的正常妊娠孕妇（对照组）的血浆同型半胱氨酸水平。用Logistic回归分析等统计方法分析孕妇血浆同型半胱氨酸水平与早产的相关性。结果：病例组血浆同型半胱氨酸水平（7．56±2．97μmol／L）显著高于对照组（5．96±2．54μmol／L），P=0．013；排除混杂因素的影响，早产孕妇血浆同型半胱氨酸水平升高没有明显增加早产发生的风险，其血浆同型半胱氨酸水平升高会增加分娩早产小于胎龄儿（SGA）的机会，尤其是血浆同型半胱氨酸水平≥11．0μmol／L时分娩SGA的机会明显增加（x^2=8．579，P=0．003）；未见早产儿其他并发症增加。结论：孕妇血浆同型半胱氨酸水平升高不会明显增加早产发生的风险，而会显著增加分娩小于胎龄儿的机会。

Objective： To study the relationship between plasma homocysteine level in pregnant women and premature delivery. Methods： Plasma homocysteine levels in 60 aborted women of 28 - 34 gestational weeks （ case group） and 30 normal pregnant women of 31 - 34 gestational weeks （study group） were detected by high performance liquid chromatography with fluorescence detection, case - control study was adopted, the correlation between plasma homocysteine level and premature delivery was analyzed by Logistic regression analysis. Results： The plasma homocysteine level in case group was （7. 56 ± 2. 97） μmol/L, which was significantly higher than that in control group [ （5. 96 ±2. 54） μmol/L] （P =0. 013） ; the increase of plasma homocysteine level in case group didnt elevate the risk of premature delivery except confounding factors, the increase of plasma homocysteine level elevated the opportunity of small for gestational age infant （SGA）, especially plasma homocysteine level≥ 11.0 μmol/L （X2 = 8.597, P = 0. 003 ） ; but the incidence of other complications of preterm infants didnt increase. Conclusion： The increase of plasma homocysteine level of pregnant women dont elevate the risk of premature delivery, but increase the delivering rate of SGA.