孕妇羊水同型半胱氨酸、叶酸及Vit B_(12)与胎儿畸形的关系

Association of amniotic fluid homocysteine,folate and cobalamin levels with birth defects

目的:测定胎儿畸形孕妇羊水tHcy、叶酸及Vit B12的水平,了解其与胎儿畸形的关系。方法:根据有无胎儿畸形将研究对象分为两组,病例组(n=68)及对照组(n=68)。采用全自动荧光偏振免疫发光法测定两组孕妇羊水中tHcy水平,同时用离子捕捉免疫分析法测定其羊水中叶酸水平,用微粒子酶联免疫分析法测定其羊水中Vit B12水平。结果:病例组的年龄显著小于对照组(P<0.001),抽取羊水的孕周大于对照组(P<0.05),病例组羊水tHcy水平高于对照组(P<0.05),羊水叶酸水平低于对照组(P<0.05),羊水Vit B12水平则显著低于对照组(P<0.001)。结论:胎儿畸形患者羊水中tHcy明显升高,而叶酸及Vit B12水平降低,高tHcy增加了胎儿畸形发病的风险,补充叶酸及Vit B12是降低胎儿畸形发生率的有效措施。

Objective To explore the relationship between amniotic fluid homocystenine,folate,cobalamin and birth defects.Method Total homocysteine,folate,cobalamin were respectively measured by fluorescence polarization immunoassay（FPIA）,ion capture immunoassay（ICIA）,microparticle enzyme immunoassay（MEIA） in the amniotic fluid of 68 women who were pregnant with a child having birth defect and in 68 women pregnant with a non-malformed child.Results The women in cases were significantly younger than those in controls（P0.001）.The gestational weeks in cases were greater than in controls（P0.05）.The tHcy concentration in cases was higher than in controls（P0.05）.The folate concentration in cases was lower than in controls（P0.05）.The cobalamin concentration in cases was significantly lower than in controls（P0.001）.Conclusion The level of tHcy is significantly elevated and the level of folate and cobalamin are reduced in the amniotic fluid of women who are pregnant with a child having birth defect.High level of tHcy increases the risk of fetal malformations.Supplement of folic acid and cobalamin is an effective measure to reduce the incidence of fetal malformations.