单胎妊娠女性同型半胱氨酸参考区间的建立

Establishment of homocysteine reference intervals in women with singleton pregnancy

目的建立本实验室单胎妊娠女性同型半胱氨酸(Homocysteine,Hcy)参考区间,探讨同型半胱氨酸孕期变化规律,为妊娠并发症诊疗提供参考依据。方法选取2018年2月至2020年2月到该院建档的3621例正常单胎妊娠女性为研究对象,其中早孕期125例、中孕期1175例、晚孕期2321例,选择非妊娠健康体检女性90例为对照组,用日立008as生化分析仪检测各组血清Hcy,采用P_(2.5)~P_(97.5)确定参考区间。结果(1)Hcy参考区间:早、中、晚孕期分别为:0.99~14.05μmol/L、0.62~8.88μmol/L、1.73~11.67μmol/L,各组间差异有统计学意义(P<0.05)。(2)妊娠组Hcy较低于非妊娠组(P<0.05)。结论妊娠女性血清Hcy水平较非妊娠期低,Hcy随孕周变化而波动,孕早期即开始下降,以孕中期最低,孕晚期逐渐升高,早、中、晚孕期Hcy差异有统计学意义;妊娠女性各期Hcy参考区间与试剂说明书不同,实验室建立妊娠女性Hcy特有参考区间对及时提示妊娠并发症有重要的意义。

Objective To establish the reference intervals of Homocysteine(Hcy)and investigate the changes of Hcy during pregnancy in the singleton pregnancy women,so as to provide references for the diagnosis and treatment of pregnancy complications.Methods A total of 3621 healthy singleton pregnancy women from February 2018 to February 2020 were randomly selected,who were divided into three groups according to gestational age which 125 in first trimester,1175 in second trimester and 2321 in third trimester.And 90 healthy non-pregnant Chinese women were randomly selected as the non-pregnant control group.Serum Hcy of each group was detected by Hitachi 008as biochemical analyze,ranges between the 2.5th and 97.5th percentiles were defined as reference intervals for Hcy.Results The reference intervals for the first,second and third trimester of Hcy were 0.99~14.05μmol/L,0.62~8.88μmol/L and 1.73~11.67μmol/L,respectively,and there were statistical significantly differences between different groups(P<0.05).Hcy level in pregnancy group was lower than that of non-pregnancy group,and there were statistical significantly differences between different groups(P<0.05).Conclusions Serum Hcy level of pregnant women is lower than that of non-pregnant women.Hcy level change at different gestation periods,and began to decline in the first trimester,with the lowest in the second trimester,and gradually increased.The Hcy reference interval for pregnant women of each trimester is different from the one given from reagent specification,the establishment of the pregnancy-specific reference intervals of Hcy is essential for diagnosis and treatment of pregnancy complications.