血清叶酸及同型半胱氨酸与出生缺陷的关系  

Correlation between serum FA,HCY of pregnant woman and birth defect

作　　者：周艳红 王华[2] 刘穆军[3] 王新[4] 

机构地区：[1]湖南省益阳市中心医院 [2]湖南省妇幼保健院 [3]长沙市妇幼保健院 [4]中南大学湘雅二医院妇产科,湖南长沙410011

出　　处：《中国优生与遗传杂志》2009年第3期109-111,34,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨血清叶酸及同型半胱氨酸水平与出生缺陷发生的关系及在产前诊断中的价值。方法选择孕中期产前筛查高风险且产前诊断胎儿有先天性异常的孕妇19例为A组,孕中期产前筛查高风险,但产前诊断胎儿正常的孕妇60例为B组,孕中期产前筛查低风险,经B超检查(部分经彩超检查)未见胎儿有CHD、NTD、CL且产后新生儿检查未见上述畸形的孕妇26例为C组,采用免疫荧光时间分辨法测定血清FA,化学发光法测定血清Hcy。结果1.A组血清FA平均值为18.90±5.65 nmol/L,B组血清FA平均值为25.40±8.06 nmol/L,C组血清FA平均值为36.46±11.27 nmol/L,三组血清FA水平两两比较,差异有统计学意义(P<0.01)。2.A组血清Hcy平均值为19.62±6.01μmol/L,B组血清Hcy平均值为15.78±2.29μmol/L,C组血清Hcy平均值为13.05±2.10μmol/L,三组间两两比较,差异有统计学意义(P<0.001)。3.统计学分析显示,三组血清FA与Hcy均存在明显负相关(P<0.05)。结论1.母体内血清FA水平低下、Hcy升高对出生缺陷有着重要的影响;2.FA与Hcy存在明显负相关,提示血清FA异常对Hcy有重要影响;3.母体血清FA浓度<21.55 nmol/L和/或Hcy浓度>19.90μmol/L有可能作为产前筛查高风险孕的妇产前诊断的新指征。Objective ： To investigate the correlation between the level of serum folic acid （FA） and homocysteine （Hcy） and birth defects, and the value in prenatal diagnosis. Methods： 19 pregnant women who were high risk by prenatal screening and had congenital abnormal fetus by prenatal diagnosis were selected as group A; 60 pregnant women who were high risk by prenatal screening and had normal fetus by prenatal diagnosis were selected as group B ; 26 pregnant women who were low risk by prenatal screening and had the fetal who weren＇t discovered CHD, NTD and CL by type B ultrasonic （part of them were examined by color ultrasonic） and also werent discovered those malformation post partum by neonate examination were selected as group C. The concentration of serum FA was measured by the time -resolved immunofluorometric assay （TRIFMA）. The concentration of serum Hcy was measured by the chemiluminescent immunoassay. Results： 1. The mean of serum FA in the group A, group B and group C was 18.90 ±5.65 nmol/l, 25.40 ± 8.06nmol/L and 36. 46 ± 11.27nmol/1, respectively. There were significant correlation in the three groups （ P 〈 0.01 ）. 2. The mean of serum Hcy in group A, group B and group C was 19. 62±6. 01μmol/L, 15. 78 ±2. 29μmol/L and 13. 05 ±2. 10μmol / L, respectively. There were very significant correlation in three groups （ P 〈0. 001 ）. 3. Statistical analysis show the negative correlation between serum FA and Hcy in three groups （ P 〈 0. 05 ）. Conclusion ： 1. The low - level of maternal serum FA and high - level of maternal serum Hcy indicated that there were significant effect in birth defects. 2. Statistical analysis showed the negative relationship between serum FA and Hcy, indicated that serum FA abnormity played a important effect in Hcy. 3. The concentration of serum FA was less than 21.55nmol/L or or and serum Hey was more than 19. 90μmol/L may be the important symbols of prenatal diagnosis of the pregnant women who were high risk by prenatal screening.

关 键 词：出生缺陷 叶酸 同型半胱氨酸 产前筛查 产前诊断 

分 类 号：R714.55[医药卫生—妇产科学]