晚发型VitK缺乏性出血高发区孕妇及新生儿VitK状况的研究

Vitamin K status in pregnant women and their newborns in high incidence area of late Vitamin K deficiency bleeding

研究晚发型VitK缺乏性出血高发地区孕妇及其新生儿的VitK营养状况。山东省栖霞县是迄今为止晚 发型VitK缺乏性出血发病率最高的地区。采用凝血酶原前体蛋白（PIVKA-Ⅱ）的ＥＬＩＳＡ法测定了栖霞县７６名健康孕 妇及其新生儿血清凝血酶原前体蛋白（PIVKA－Ⅱ）水平。结果显示：孕妇凝血酶原前体蛋白阳性率为３１．５８％;新生儿为 ５５．２６％。凝血酶原前体蛋白阳性孕妇，其新生儿凝血酶原前体蛋白阳性的几率为７０．８３％。凝血酶原前体蛋白同时阳性 的１７例孕妇及其新生儿中，孕妇和新生儿水平有相关性（相关系数为０．５２６，Ｐ＜０．０５）。母亲凝血酶原前体蛋白阴性，其 新生儿阳性的几率为４８．０８％。提示：当孕妇有亚临床VitK缺乏时，其分娩的新生儿大部分将发生VitK缺乏。孕妇VitK 缺乏会导致新生儿VitK缺乏。即使孕产妇不存在亚临床VitK缺乏，由于胎盘屏障的作用，仍有４８．０８％的新生儿会发 生亚临床VitK缺乏。

Objective: To study Vitamin K nutrition status Vitamin K status in pregnant women and their newborns in high incidence area of late Vitamin K deficiency bleeding. Methods: Serum PIVKA-Ⅱ were measured by ELlSA basing on the PIVKA-Ⅱ monoclonal antibody in 76 cases of healthy pregnant women and paired new- borns of Qixia county of Shandong Province. Results: ①24 out of 76cases of pregnant women are positive in PIVKA-Ⅱ. The positive rate of PIVKA-Ⅱ is 31. 58%. 42 out of 76 cases of newborns are positive in PIVKA- Ⅱ. The positive rate of PIVKA-Ⅱ is 55. 26%. Both pregnant women and their newborns have not correlation in PIVKA-Ⅱ. ② In 24 cases of pregnant women being positive PIVKA-Ⅱ, 17 cases of newborns are positive in PIVKA-Ⅱ. The positive rate of PIVKA-Ⅱ is 70. 8%. 18 cases of pregnant women and their newborns have cor- relation in PIVKA-Ⅱ (r=0. 526, P <0. 01). ③ In 52 cases of pregnant women being negative PIVKA-Ⅱ, 25 cases of paired newborns are positive in PIVKA-Ⅱ. The positive rate of PIVKA-Ⅱ is 48. 8%. Conclusion: The positive rate of PIVKA-Ⅱ is higher in pregnant women and their newborns in high incidence area of late Vita- min K deficiency bleeding. Subclinical Vitamin K deficiency of pregnant women could resu1t in subclinical Vita- min K deficiency of their newborns. Even if pregnant women do not express subclinical Vitamin K deficiency, their newborns could be subclinical Vitamin K deficiency.