叶酸代谢障碍联合同型半胱氨酸检测对不明原因复发性流产患者的临床意义

Clinical significance of folic acid metabolism disorder combined with homocysteine detection in patients with unexplained recurrent spontaneous abortion

目的探讨叶酸代谢障碍联合同型半胱氨酸检测对不明原因复发性流产患者的临床意义,为临床治疗和预防提供参考依据。方法收集我院生殖中心自2018年1月~2020年1月收治的不明原因复发性流产(URSA)患者50例为研究对象,同期收集我院门诊非孕期育龄妇女,且没有不良妊娠史且至少有1次正常生育史的患者50例作为对照组,通过棉签搔刮口腔黏膜组织检测两组叶酸代谢障碍,同时收集两组人群的血清,检测同型半胱氨酸(Hcy)水平并分析高Hcy与妇女发生URSA的相关性。结果观察组叶酸代谢障碍遗传检验示高度风险15例(30%),中度风险25例(50%),低度风险3例(6%),未发现风险7例(14%);对照组高度风险5例(10%),中度风险8例(16%),低度风险10例(20%),未发现风险27例(54%),差异有统计学意义(P<0.05)。观察组血清Hcy水平高于对照组,差异有统计学意义(P<0.05),且观察组的Hcy水平与叶酸代谢障碍遗传检验呈正相关(P<0.01),对照组Hcy水平与叶酸代谢障碍遗传检验无相关性(P>0.05)。结论通过检测叶酸代谢障碍及血清Hcy有助于URSA的诊断及预后的判断,叶酸代谢障碍遗传检验异常及高Hcy血症均是导致URSA发生的重要危险因素,在临床诊治中要加以关注。

Objective To explore the clinical significance of folic acid metabolism disorder combined with homocysteine detection in patients with unexplained recurrent abortion,and to provide reference for clinical treatment and prevention.Methods A total of 50 patients with unexplained recurrent spontaneous abortion(URSA)admitted in our hospital's reproductive center from January 2018 to January 2020 were collected as research subjects.Fifty non-pregnant women of childbearing age who had no history of bad pregnancy and had at least one normal fertility history were used as the control group.The folic acid metabolism disorder in two groups was detected by scratching the oral mucosa tissue with cotton swabs.At the same time,serum of two groups was collected.The homocysteine(Hcy)levels were detected.And the correlation of high Hcy with URSA in women analyzed.Results The genetic test of folic acid metabolism disorder in the observation group showed 15 cases(30%)with high risk,25 cases(50%)with moderate risk,3 cases(6%)with low risk,and 7 cases(14%)with no risk.There were 5 cases of high risk(10%),8 cases of moderate risk(16%),10 cases of low risk(20%),and 27 cases of no risk in the control group(54%).The difference was significant(P<0.05).The serum Hcy level in the observation group was higher than that in the control group,and the difference was significant(P<0.05).The Hcy level in the observation group was positively correlated with the genetic test for folate metabolism disorders(P<0.01).The Hcy level in the control group was not related to the genetic test for folic acid metabolism disorders(P>0.05).Conclusion The detection of folic acid metabolism disorder and serum Hcy can contribute to the diagnosis and prognosis judgment of URSA.Abnormality of genetic test for folic acid metabolism disorder and hyper Hcyemia are important risk factors leading to the occurrence of URSA,and should be paid attention to in clinical diagnosis and treatment.