孕妇血铜与子痫前期的病例对照研究

A case-control study on the relationship between maternal copper and preeclampsia

目的了解孕妇血铜(copper, Cu)水平及其与子痫前期的关系,探讨孕妇血Cu对子痫前期的影响。方法以山西医科大学第一医院产科分娩的427例子痫前期孕妇为病例组,按成组匹配的方法随机选取427例非妊娠期高血压疾病孕妇作为对照组。采用面对面调查和病历查阅的方式收集孕妇人口学特征、生育史、妊娠及健康状况、行为生活方式、高血压家族史和新生儿出生情况等资料,采用电感耦合等离子体质谱法(inductively coupled plasma mass spectrometry, ICP-MS)测定血Cu水平。结果子痫前期组和对照组血Cu中位数和四分位数分别为1.31(1.07,1.60)mg/L和1.31(1.06,1.56)mg/L(Z=0.41,P=0.685)。早发子痫前期与晚发子痫前期孕妇血Cu中位数和四分位数分别为1.25(1.04,1.56)mg/L和1.34(1.08,1.61)mg/L(Z=1.78,P=0.075),子痫前期组与对照组及不同临床亚型子痫前期组孕妇血Cu水平差异均无统计学意义(均有P>0.05)。Logistic回归分析模型分析结果显示,控制了文化程度、经济收入、孕前体重指数(body mass index, BMI)、孕期增重、产次、妊娠期糖尿病、高血压家族史和其他元素等后,未发现孕妇血Cu与子痫前期、早发子痫前期和晚发子痫前期的发生有关。结论尚不能认为孕妇血Cu水平与子痫前期及其亚型的发生有关。

Objective To investigate the level of copper(Cu) in pregnant women with preeclampsia and normotensive pregnant women, and their relationship with risk of preeclampsia. Methods A frequency matching case-control study was performed among the pregnant women who gave birth between March 2012 and September 2016 in the First Hospital of Shanxi Medical University. A total of 427 pregnant women with preeclampsia were as cases. 427 normotensive pregnant women matched for date of conception, residence, and age were randomly selected as controls. Demographic characteristics, childbearing history, pregnancy and health condition, behavior and lifestyle, family history of hypertension, and newborn birth condition were collected by face to face investigation and medical records review. Inductively coupled plasma mass spectrometry(ICP-MS) was used to determine levels of copper, manganese, zinc, and selenium in the maternal blood. Results The distribution of maternal blood copper was skewed, and the median and inter-quartile range of copper concentration in the preeclampsia and control group were 1.31(1.07, 1.60) mg/L and 1.31(1.06, 1.56) mg/L(Z=0.41, P=0.685). The median and quartile values of blood Cu in pregnant women with early and late preeclampsia were 1.25(1.04, 1.56) mg/L and 1.34(1.08, 1.61) mg/L(Z=1.78, P=0.075), respectively. There were no significant differences in blood Cu levels between the preeclampsia group, the control group and the pre-eclampsia group with different clinical subtypes(all P>0.05). The results of Logistic regression analysis model showed that after the control of the level of education, income, pre-pegant body mass index, pregnancy weight gain, parity, gestational diabetes, family history of high blood pressure, and other elements, such as pregnant women were not found in the blood Cu with preeclampsia, early onset preeclampsia, and later in the pathogenesis of preeclampsia. Conclusions It can not be considered that maternal blood copper is related with preeclampsia and its subtypes.