孕妇血清Fol、VB_(12)和Hcy水平与胎儿CHD相关性研究  

Correlation study of fetus congenital heart disease and serum folate,vitamin B_(12) and homocysteine in pregnant women

作　　者：陈益明[1] 顾琳媛 王芳[2] 褚雪莲 林黎春 黄灵[1] 王洁[2] 王亚男[1] 

机构地区：[1]杭州市余杭区妇幼保健院检验科,浙江杭州311100 [2]杭州市余杭区妇幼保健院妇保科,浙江杭州311100 [3]杭州市余杭区妇幼保健院超声科,浙江杭州311100

出　　处：《中国妇幼健康研究》2014年第6期966-968,共3页Chinese Journal of Woman and Child Health Research

基　　金：浙江省医药卫生科技计划资助项目(2012KYB173)

摘　　要：目的 比较胎儿先天性心脏病（ CHD）的孕妇和正常孕妇血清叶酸（ Fol）、维生素B12（ VB12）和同型半胱氨酸（ Hcy）水平，以了解3种物质的代谢水平与胎儿CHD的关系。方法 根据有无胎儿CHD将研究对象分为病例组（ n＝46）和对照组（n＝43）。病例组为经B超诊断为孕CHD胎儿确诊的孕妇，对照组为经B超诊断胎儿发育正常的孕妇。检测89例研究对象血清标本Fol、VB12和Hcy水平，比较病例组和对照组血清Fol、VB12和Hcy水平差异。结果 病例组的Fol水平高于对照组，差异有统计学意义（t＝2．426，P＝0．017）；病例组Hcy水平高低于对照组，但差异无统计学意义（P＞0．05）。血清Fol≥44．5nmol／L的孕妇与＜38．6nmol／L的孕妇相比，胎儿CHD发生率降低36倍；Hcy的OR＝1．036（95％CI：0．807～1．329），但并未增加胎儿CHD发生的危险性（P＞0．05）；VB12的OR＝1．007（95％CI：1．001～1．013），增加胎儿CHD发生的危险性（P＝0．015）。 Fol和VB12对CHD的发生都有关联，差异均有统计学意义（P＝0．046，P＝0．020），但是曲线下的面积都＜70％，用这两个指标单独进行诊断无很大价值。结论 孕妇高水平Fol是妊娠胎儿CHD的保护因素，VB12是妊娠胎儿CHD的危险因素，血清Fol和VB12联合检测对胎儿CHD的发生更有预测价值。Objective To compare the levels of folate （Fol）, vitamin B12（VB12） and homocysteine （Hcy） between pregnant women with congenital heart disease （ CHD） fetus and those with healthy fetus , and to investigate the relation between fetus CHD and the above three levels.Methods All cases were divided into case group （n=46） and control group （n=43） according to whether they had CHD fetus .By diagnosing with ultrasound scans , the pregnant women with CHD fetus were in the case group , and the pregnant women with healthy fetus were in the control group .The levels of Fol , VB12 and Hcy in 89 samples were detected and compared between two groups .Results The level of Fol in the case group was higher than in the control group , and the difference was significant （t=2.426,P=0.017）.The level of Hcy in the case group was lower than the control group , but there was no statistical difference （P〉0.05）.Compared with the pregnant women with Fol≥44.5nmol/L, the incidence of fetus CHD among those with Fol 〈38.6nmol/L reduced 36 times.Hcy with OR value of 1.036 （95%CI：0.807-1.329） didn＇t increase the risk of fetus CHD （P〉0.05）, but VB12with OR value of 1.007 （95%CI：1.001-1.013） did （P=0.015）.Both Fol and VB12 were related with the incidence of fetus CHD , and the difference was significant （P=0.046, P=0.020）.However, ROV area of them was less than 70%, so it was not valuable to diagnose fetus CHD by detecting Fol or VB 12. Conclusion High level of Fol is a protective factor and VB 12 is a dangerous factor for fetus CHD .It is valuable by combined detecting of Fol and VB12 in diagnosing fetus CHD .

关 键 词：叶酸 维生素B12 同型半胱氨酸 先天性心脏病 

分 类 号：R714[医药卫生—妇产科学] R714.5[医药卫生—临床医学]