MTHFR基因检测及孕期补充叶酸与子痫前期发病风险的相关分析

Correlation analysis between MTHFR gene detection, folic acid supplementation during pregnancy and risk of pre-eclampsia

目的评估孕期补充叶酸和MTHFR基因多态性分析与子痫前期发病风险的相关性,为子痫前期早期风险预测和预防提供新思路。方法筛选2017年6月-2018年5月于保定市妇幼保健院产科检查经子宫动脉多普勒波分析判定为子痫前期高风险的初产孕妇215例。随机分为干预组A(n=72)、干预组B(n=72)和对照组(n=71),分别给予0.8mg叶酸、0.4mg叶酸和酵母片。统计子痫前期和并发症的发生情况。根据子痫前期发生与否,将受试者分为子痫前期(PE)组和正常组,检测分析MTHFR基因C677T位点多态性,检测比较PE组和正常组不同基因型孕妇血清中同型半胱氨酸(Hcy)代谢指标的含量和叶酸水平。结果对照组的PE发病率明显高于干预组A和B(P<0.05),干预组A和B的PE发病率无明显差异(P>0.05);对照组重度子痫前期的发病率显著高于干预组A和干预组B(P<0.05);3组PE并发症发生情况无明显差异(P>0.05)。PE组孕妇TT基因型和T677等位基因频率显著高于正常组(P<0.05);CC基因型和C677等位基因频率显著低于正常组(P<0.05)。PE组孕妇血清Hcy含量均显著高于正常组(P<0.05),TT基因型的PE孕妇Hcy显著高于CT和CC基因型(P<0.05),正常组不同基因型的Hcy含量无明显差异(P>0.05)。PE组孕妇血清叶酸含量均显著低于正常组(P<0.05),TT基因型、CT基因型和CC基因型叶酸含量逐步递升,组间差异均有统计学意义(P<0.05)。正常组CC基因型叶酸含量显著高于TT基因型和CT基因型(P<0.05),TT基因型和CT基因型间无明显差异(P>0.05)。结论MTHFR基因C677T多态性和补充叶酸与子痫前期的发病风险有一定相关性,在子痫前期高风险孕妇中进行MTHFR基因C677T多态性分析,及时补充叶酸,有助于预防子痫前期发生。

Objective To evaluate the correlation between the analysis of folic acid and MTHFR gene polymorphism during pregnancy and the risk of preeclampsia,and to provide new ideas for early risk prediction and prevention of preeclampsia.Methods A total of 215primiparous pregnant women with high risk of pre-eclampsia were identified from the obstetric examination of the Baoding Maternal and Child Health Hospital from June 2017to May 2018.They were randomly divided into intervention group A(n=72),intervention group B(n=72),and control group(n=71),and 0.8mg of folic acid,0.4mg of folic acid,and yeast tablets were administered per day,respectively.The incidence of preeclampsia and complications were counted.According to whether pre-eclampsia occurred,the subjects were divided into pre-eclampsia(PE)group and normal group.The MTHFR gene C677Tlocus polymorphism was detected and analyzed.The Hcy metabolism and folic acid levels in serum of pregnant women with different genotypes in the PE group and normal group were compared.Results The incidence of PE in the control group was significantly higher than that in the intervention group(P<0.05).There was no significant difference in the incidence of PE between the intervention group A and B(P>0.05).The incidence of severe pre-eclampsia in the control group significantly higher than the intervention group A and intervention group B(P<0.05);there was no significant difference in PE complications between the groups(P>0.05).The frequencies of TT genotype and T677allele in the PE group were significantly higher than those in the normal group(P<0.05).The frequencies of CC genotype and C677allele were significantly lower than those in the normal group(P<0.05).The serum Hcy content of pregnant women in the PE group was significantly higher than that in the normal group(P<0.05).The Hcy of pregnant women with TT genotype was significantly higher than that of CT and CC genotypes(P<0.05).The Hcy content of different genotypes in the normal group was not significant.difference(P>0.05).The serum folic acid content of pregnant women in the PE group was significantly lower than that of the normal group(P<0.05).The levels of TT genotype,CT genotype and CC genotype increased gradually,and the differences between groups were statistically significant(P<0.05).The folic acid content of CC genotype in the normal group was significantly higher than that of TT genotype and CT genotype(P<0.05).There was no significant difference between TT genotype and CT genotype(P>0.05).Conclusion The M677Rgene C677Tpolymorphism and the supplementation of folic acid have a certain correlation with the risk of pre-eclampsia.The MTHFR gene C677Tpolymorphism is analyzed in high-risk pregnant women with pre-eclampsia,and folic acid supplementation in the early stage is helpful to prevent the occurrence of pre-eclampsia.