孕妇血浆同型半胱氨酸水平对胎儿的影响

Effect of plasma homocysteine level of pregnant women on fetuses

目的:比较妊娠畸形胎儿的孕妇及正常胎儿的孕妇血浆中同型半胱氨酸(homocysteine,Hcy)水平,分析其代谢水平与妊娠畸形胎儿的关系。方法:采用病例对照研究方法,对所有研究对象采集孕妇静脉血及新生儿脐静脉血3 ml,检测其血清Hcy水平,比较病例组和对照组血清Hcy的差异。研究血清Hcy水平与年龄、孕周、胎儿体重之间的关系。以对照组血清Hcy浓度的第90百分位数作为界值,划分为两个水平组,比较不同水平组胎儿先天畸形的发病风险。结果:病例组孕妇血清Hcy明显高于对照组(18.23μmol/L vs 9.52μmol/L),差异有统计学意义(P<0.05)。与年龄、孕周、胎儿体重之间无必然联系。高水平Hcy孕妇妊娠先天畸形胎儿的危险性显著增加(OR=2.4,P<0.05)。结论:孕期血清Hcy高水平是研究胎儿先天畸形发生的危险因素。

Objective：To compare the plasma levels of homocysteine（Hcy） between pregnant women giving birth to fetuses with congenital malformations and pregnant women giving birth to normal fetuses,and analyze the relationship between metabolic level of Hcy and fetuses with congenital malformations.Methods：A case-control study was performed,3 ml venous blood samples and 3 ml umbilical cord blood samples were Abstracted from all the pregnant women and all the fetuses,respectively,serum Hcy levels were detected,and the difference of serum Hcy was compared between case group and control group.The relationship between serum Hcy level and age,gestational weeks,and fetal weight was researched.The 90th percentile of serum Hcy concentration in control group was selected as critical value,the cases were divided into two groups,the risk factors of fetal congenital malformations were compared between the two groups.Results：The serum Hcy level in case group was 18.23 μmol/L,which was statistically significantly higher than that in control group（9.52 μmol/L）（P0.05）,there was no significant correlation between serum Hcy level and age,gestational weeks,and fetal weight.The risk of congenital malformations in fetuses born by pregnant women with high Hcy level increased significantly（OR=2.4,P0.05）.Conclusion：High serum Hcy level during gestational period is one of risk factors of congenital malformations in fetuses.