血清同型半胱氨酸在胚胎停止发育中检测的临床意义

Clinical significance of serum homocysteine in embryon stopping development

目的探讨胚胎停止发育孕妇血清同型半胱氨酸(HCY)的动态变化及其临床价值。方法选择育龄期妇女176例,分胚胎停止组76例、正常胚胎组50例、正常育龄组50例;抽取3组妇女空腹静脉血3 ml,高速离心取血清,用双试剂循环酶法检测血清HCY水平,7 d测1次,连续测量3次;胚胎停止发育组人工流产送病理检查分析;观察3组血清HCY的动态变化及不同病理结果间的差异。结果胚胎停止组隔周检测血清HCY呈上升趋势(P<0.05),正常胚胎组和育龄对照组隔周检测HCY无明显变化(均P>0.05);胚胎停止组HCY均高于正常胚胎组和育龄对照组同次检测结果(P<0.05)。胚胎停止发育者病理结果孕囊有绒毛组血清HCY明显高于孕囊无绒毛组(P<0.05);孕囊有绒毛伴血栓者血清HCY明显高于孕囊无绒毛有伴血栓者(P<0.05),孕囊有绒毛无血栓者血清HCY明显高于孕囊无绒毛无血栓者(P<0.05);孕囊有或无绒毛者胚胎有血栓者的血清HCY均明显高于无血栓者(均P<0.05)。结论胚胎停止发育孕妇血清同型半胱氨酸可能存在升高现象,其值大小与胚胎病理结果有一定的相关性;因此,血清同型半胱氨酸检测对胚胎停止发育的诊断及预后评估具有一定的临床价值。

Objective To study the dynamic change and clinical value of serum homocysteine among embryon stopping development. Methods One hundred and seventy-six women of child-bearing age were chosen in this study; among those, 76 cases were divided into embryo stopping group, 50 cases normal embryo group and 50 cases normal childbearing age group. Three milliliter of fasting venous blood were extracted from all the women. Serum was taken by high-speed centrifugal; and concentrations were tested in the method of double reagent enzymatic cycles, once every seven days and three times in a row. Abortion in embryo stopping group was sent to pathologic examination and analysis. Dynamic change of the serum homocysteine concentrations of three groups and the differences among the various pathological results were observed. Results HCY of embryo stopping group was on the rise （P 〈 0.05）. HCY of normal embryo group and normal childbearing age group and the did not change obviously （P 〉 0.05）. HYC in embryo stop group was higher than that of the normal embryo group and childbearing group at the same examine time （P 〈0.05）. HCY of pregnancy bursa with villus was higher than that of without villus （P 〈 0.05）; HCY of pregnancy bursa with villus and thrombus was much higher than that of without villus and thrombus （P 〈 0.05）; HCY of pregnancy bursa with or without villus but with thrombus was higher than that of the non thrombus （P 〈 0.05）. Conclusions If the embryonic development stops, serum homocysteine of the pregnant women may increase. There＇s a certain relevance between their value and the embryo pathology result. Therefore, there＇s a certain clinical value for serum homocysteine detection to the diagnosis and prognosis of embryonic development stops.