分娩前静脉血铬水平与子痫前期的病例对照研究

A case-control study of venous blood chromium levels before delivery and preeclampsia

目的探讨分娩前静脉血铬(chromium,Cr)水平与孕妇子痫前期(preeclampsia,PE)及其临床亚型的发生风险的关系。方法研究对象为2012年3月―2016年9月在山西医科大学第一医院产科住院分娩的孕妇,从中随机选取442例PE病例[195例早发型子痫前期(earlyonset PE,EOPE)和247例晚发型子痫前期(late-onset PE,LOPE)]和1745例正常妊娠孕妇。收集其一般人口学特征、疾病史、家族史等,以及检测其全血中的重金属Cr浓度。经非条件Logistic回归分析模型分析Cr暴露对PE及其临床亚型的发生风险的影响。结果PE组孕妇全血Cr暴露水平为[9.54(3.40,39.26)]μg/L,其中EOPE组为[9.75(3.56,55.38)]μg/L,LOPE组为[9.36(3.21,39.24)]μg/L,均高于与正常妊娠孕妇的[7.02(0.10,30.05)]μg/L(均有P<0.05)。经非条件Logistic回归分析,调整孕妇年龄、文化程度、家庭人均月收入等混杂因素后,Cr暴露与PE及其临床亚型的发生风险均有关,且对EOPE影响更大。结论妊娠Cr暴露与PE的发生风险有关,并与EOPE的发病风险关联更大。

Objective To investigate the relationship between chromium(Cr)exposure during pregnancy and the risk of preeclampsia(PE)and its clinical subtypes.Methods The research subjects were pregnant women who gave birth in the Obstetrics department of the First Hospital of Shanxi Medical University from March 2012 to September 2016.A total of 442 cases of PE[195 cases of early-onset PE(EOPE)and 247 cases of late-onset PE(LOPE)]and 1745 normal pregnant women were randomly selected.The general demographic characteristics,disease history,family history,etc.were collected,and the concentration of heavy metal Cr in whole blood was detected.Unconditional Logistic regression was used to analyze the level of Cr exposure and the risk of PE and its clinical subtypes.Results The whole blood Cr exposure level of pregnant women in the PE group was[9.54(3.40,39.26)]μg/L,that in the EOPE group was[9.75(3.56,55.38)]μg/L,and that in the LOPE group was[9.36(3.21,39.24)]μg/L,which were higher than that of normal pregnant women with[7.02(0.10,30.05)]μg/L(all P<0.05).Using unconditional Logistic regression analysis,after adjusting for confounding factors such as pregnant women’s age,education level,and per capita monthly income,Cr exposure levels were related to the risk of PE and its different clinical subtypes,and it was associated with a higher risk of EOPE.Conclusion Cr exposure in pregnancy is related to the risk of PE,and is more related to the risk of EOPE.