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目的:比较妊娠畸形胎儿的孕妇及正常胎儿的孕妇血浆中同型半胱氨酸(homocysteine,Hcy)水平,分析其代谢水平与妊娠畸形胎儿的关系。方法:采用病例对照研究方法,对所有研究对象采集孕妇静脉血及新生儿脐静脉血3 ml,检测其血清Hcy水平,比较病例组和对照组血清Hcy的差异。研究血清Hcy水平与年龄、孕周、胎儿体重之间的关系。以对照组血清Hcy浓度的第90百分位数作为界值,划分为两个水平组,比较不同水平组胎儿先天畸形的发病风险。结果:病例组孕妇血清Hcy明显高于对照组(18.23μmol/L vs 9.52μmol/L),差异有统计学意义(P<0.05)。与年龄、孕周、胎儿体重之间无必然联系。高水平Hcy孕妇妊娠先天畸形胎儿的危险性显著增加(OR=2.4,P<0.05)。结论:孕期血清Hcy高水平是研究胎儿先天畸形发生的危险因素。
Objective: To compare the homocysteine (Hcy) levels in pregnant women with gestational malformation fetuses and their normal fetuses, and to analyze the relationship between the level of homocysteine (Hcy) and the fetus with gestational malformations. Methods: A case-control study was conducted to collect 3 ml of cord blood of pregnant women and umbilical cord blood of neonates for all the subjects. The serum Hcy level was measured. The difference of serum Hcy levels between the case group and the control group was compared. To study the relationship between serum Hcy and age, gestational age and fetal weight. The 90th percentile of serum Hcy concentration in the control group was used as the cut-off value and divided into two levels to compare the incidence of fetal congenital malformations. Results: The serum Hcy level of pregnant women in the case group was significantly higher than that of the control group (18.23μmol / L vs 9.52μmol / L). The difference was statistically significant (P <0.05). And age, gestational age, fetal weight is not necessarily related. The risk of congenital malformation fetus in pregnant women with high level of Hcy increased significantly (OR = 2.4, P <0.05). Conclusion: The high serum Hcy level during pregnancy is a risk factor for the study of fetal congenital malformations.