孕期1,25-二羟基维生素D_3和微量元素水平与不同疾病的关系研究

Study on relationship between 1,25-dihydroxyvitomin D_3 and trace elements levels and different disease during pregnancy

目的探讨孕妇血清1,25-二羟基维生素D3[1,25-(OH)2D3]、孕期微量元素与地中海贫血、妊娠期糖尿病、甲状腺功能低下、慢性疾病之间的关系。方法将2012年1月至2013年2月就诊并常规产前随诊的3 795例孕妇进行分组,根据孕期常见疾病分为不同的研究组563例(地中海贫血组392例、妊娠期糖尿病组54例、甲状腺功能低下组56例、慢性疾病组61例)和对照组3 232例,测定各组孕妇血清中1,25-(OH)2D3、血钙、血磷和血镁水平。结果地中海贫血组、妊娠期糖尿病组孕妇1,25-(OH)2D3水平高于对照组,差异有统计学意义(P<0.05),血钙低于对照组,差异有统计学意义(P<0.01);地中海贫血组孕妇血镁水平低于对照组,差异有统计学意义(P<0.01),而其余疾病组孕妇血镁水平与对照组比较,差异无统计学意义(P>0.05);各疾病组孕妇血磷水平与对照组比较,差异无统计学意义(P>0.05)。结论地中海贫血、妊娠期糖尿病对孕妇体内25-羟基维生素D、血钙水平有一定影响,在进行孕期指导时应针对不同疾病制订相应的保健和治疗策略。

Objective To investigate relationship of 1,25-dihydroxyvitomin D311,25- （OH） 2D3] and trace elements dur- ing pregnancy with the Mediterranean anemia,gestational diabetes, Hypothyroidism and chronic diseases. Methods Totally 3 795 pregnant women,who were with routine treatment in hospital from January 2012 to February 2013 ,were divided into two groups according to the types of diseases ： experimental groups（n=563 ）[（Mediterranean anemia group ,n=392）, （gestational dia- betes group, n=54 ）, （hypothyroidism group, n=56 ）, （chronic disease group, n=61 ） ] and control group （n=3 232 ）. The levels of 1,25-（OH）2D3,hlood calcium,blood phosphorus and blood magnesium of maternal serum were measured. Results The 1,25- （OH）2D3 level in Mediterranean anemia group and gestational diabetes group was higher than that in the control group, and the difference had statistical significance （P〈0.05）. The blood calcium level in Mediterranean anemia group and gestational diabetes group was lower than that in the control group with statistically significant difference （P〈0.01）. The serum magnesium level in mediterranean anemia group was lower than that in the control group with statistically significant difference （P〈0.01）, but the serum magnesium level in the other groups had no statistically significant difference（P〉0.05 ） compared with the control group. The serum phosphate level in all the experimental groups had no statistically significant difference （P〉0.05） compared with the control group. Conclusion The Mediterranean anemia and gestational diabetes have certain influence on the levels of 1,25-（OH）2D3 and blood calcium, so health and treatment strategies should be generated based on different diseases during pregnancy guidance.