妊娠期巨幼红细胞性贫血患者血清Hcy、VB12水平及与预后相关性

Analysis of the correlation between the serum Hcy and VB12 levels of the pregnant women with megaloblastic anemia during pregnancy and their prognosis

目的:探究妊娠期巨幼红细胞性贫血(MA)孕妇血清中同型半胱氨酸(Hcy)和维生素B12(VB12)水平与预后关系。方法:选取2019年1月—2020年6月在本院就诊的妊娠期MA患者76例作为贫血组,产前检查健康孕妇65例作为对照组。比较两组孕妇一般资料、血常规指标及血清Hcy和VB12水平。以贫血组妊娠结束为观察终点分为预后不良组(31例)和预后良好组(45例),分析影响MA患者预后的主要因素。结果:贫血组血红蛋白(Hb)、红细胞(RBC)、红细胞平均血红蛋白浓度(MCHC)、VB12水平均低于对照组,平均红细胞体积(MCV)、红细胞平均血红蛋白量(MCH)、Hcy水平高于对照组(P<0.05)。Pearson结果显示,贫血组血清VB12与Hb、RBC、MCHC水平呈正相关,与MCV、MCH水平呈负相关;Hcy与MCV、MCH水平呈正相关,与VB12、Hb、RBC、MCHC水平呈负相关(均P<0.05)。预后不良组年龄、体重及分娩次数与预后良好组无差异(P>0.05),Hb、RBC、MCHC、VB12水平低于预后良好组,MCV、MCH、Hcy水平高于预后良好组(均P<0.05)。多因素logistic回归分析显示,Hb、RBC、MCV、Hcy、VB12是影响妊娠期MA患者预后的危险因素(P<0.05)。结论:妊娠期MA患者血清VB12水平降低、Hcy水平升高,二者与患者血常规指标水平相关,是影响妊娠期MA患者预后的危险因素,临床应加以关注。

Objective:To explore the correlation between the serum homocysteine(Hcy)and vitamin B12(VB12)levels of the pregnant women with megaloblastic anemia(MA)during pregnancy and their prognosis.Methods:A total of 76 pregnant women with MA were selected in study group and 65 healthy pregnant women were selected in control group from January 2019 to June 2020.The general data,blood routine indexes,and serum Hcy and VB12 levels of the women were compared between the two groups.The women in the study group were divided into group A(31 women with good prognosis)and group B(45 women with bad prognosis)based on the results of the end of pregnancy.The main factors affecting the MA prognosis of the women were analyzed.Results:The levels of Hb,RBC,MCHC,and VB12 of the women in the study group were lower than those of the women in the control group,while the levels of MCV,MCH,and Hcy of the women in the study group were significant higher(P<0.05).Pearson's results showed that the serum VB12 level of the women in the study group was positively correlated with their levels of Hb,RBC and MCHC,and was negatively correlated with their levels of MCV and MCH.The serum Hcy level of the women in the study group was positively correlated with their levels of MCV and MCH,and was negatively correlated with their levels of VB12,Hb,RBC,and MCHC(all P<0.05).The levels of Hb,RBC,MCHC,and VB12 of the women in group B were significant lower than those of the women in group A,while the levels of MCV,MCH,and Hcy of the women in group B were significant higher than those of the women in group A(all P<0.05).Multivariate logistic regression analysis showed that the levels of Hb,RBC,MCV,Hcy,and VB12 were the risk factors affecting the prognosis of the women with MA during pregnancy(P<0.05).Conclusion:The serum VB12 level of the pregnant women with MA decreases,but the Hcy level of them increases,which both are related to their blood routine index levels.The serum VB12 and Hcy levels are the risk factors affecting the prognosis of pregnant women with MA in clinic,which should be paid more attention to.