母体血清维生素D水平与早发型重度子痫前期的相关性研究  

The correlation between maternal serum 25-OH-VitD concentration and early-onset severe preeclampsia

作　　者：周俐[1] 侯延庆[1] 朱艳宾[1] 尹昕[1] 

机构地区：[1]广东医学院附属南山医院,广东深圳518052

出　　处：《国际检验医学杂志》2016年第8期1032-1034,共3页International Journal of Laboratory Medicine

基　　金：广东省深圳市南山区卫生科技资助项目(南科研卫2012024)

摘　　要：目的研究妊娠早期维生素D缺乏与发生早发型重度子痫前期(EOSPE)的相关性。方法选取2013年1月至2015年1月在该院就诊的妊娠早期初次单胎妊娠且无合并症的妇女5 000例,孕周为8~13^(+6)周。用化学发光法检测血清25-羟维生素D(25-OH-VitD)水平。排除自然流产、失访及发生妊娠并发症者后余下2 988例维生素D缺乏、完成定期产检并分娩的孕妇,随机分成2组,其中1 490例(干预组)进行维生素D的补充,1 498例(未干预组)未进行特殊干预。随访两组发生EOSPE的情况。对确诊EOSPE且缺乏维生素D者118例分为后期干预组和后期未干预组2组,后期干预组额外补充维生素D。结果5 000例妊娠妇女中维生素D缺乏者占63%,不足者占32%,充足者占5%。2 988例维生素D缺乏,完成定期产检并分娩的孕妇中发生EOSPE者123例(4.1%),其妊娠早期血清维生素D水平明显低于早期维生素D充足者,两者血清25-OH-VitD水平分别为(14.06±5.05)ng/mL与(36.30±3.86)ng/mL,两者比较差异有统计学意义(P<0.05)。EOSPE发病率,干预组为2%(30/1490),未干预组为6%(93/1 498),两组间比较差异有统计学意义(P<0.05)。后期干预组和后期未干预组各种母体并发症及围生儿不良结局的发生率比较,差异均无统计学意义(P>0.05)。结论妊娠早期妇女血清维生素D缺乏与不足普遍存在。妊娠早期维生素D缺乏可增加EOSPE的发病风险。对妊娠早期维生素D缺乏者进行补充可明显降低子痫前期发病率。对确诊EOSPE且缺乏维生素D者进行维生素D补充未能改善母体并发症及围生期不良结局。Objective To study the correlation between maternal serum 25-OH-VitD concentration and early-onset severe preeclampsia（EOSPE）.Methods 5 000 early singleton pregnancy women with gestational age 8-12^（＋6） weeks and without any complications in the outpatient department of the hospital from January 2013 to January 2015 were enrolled in the study.The levels of serum 25-OH-VitD were measured by using chemiluminescence method.Only 2 988 women with Vitamin D deficiency went through regular prenatal care and delivery.The 2 988 women were divided into two groups intervention group and non intervention group whose age,BMI and gestation age were matched.Intervention group（n=1 490）received vitamin D supplementation,the non intervention group did not received the supplementation.Those patients who developed EOSPE were counted.Finally,Patients diagnosed with EOSPE and were Vitamin D deficient（n=118）were divided into two groups late intervention group and non late intervention group.The late intervention group were treated with vitamin D supplementation,The non late intervention group were only treated routinely.Results Patients with Vitamin D deficiency accounted for 63%,insufficiency 32%,normal 5%.The levels of serum 25-OH-VitD and VEGF in patients with EOSPE were significantly lower than those in normal control group（P〈0.05）.The occurrence rate of EOSPE in 2 988 women was 4.1%（123women）.The occurrence rate of EOSPE in intervention group and no intervention group were 2%（30/1 490）and 6%（93/1 498）respectively,which were statistically different（P〈0.05）.The outcome of maternal and perinatal infant in late intervention group were not significantly different from those in non late intervention group.Conclusion Vitamin D deficiency or insufficiency is a common problem in early pregnant women.The risk of EOSPE increases in early pregnant women with Vitamin D deficiency.Vitamin D supplementation in the first trimester in women with Vitamin D deficiency could significantly decrease the occurre

关 键 词：早发型子痫前期 维生素D 妊娠并发症 

分 类 号：R714.244[医药卫生—妇产科学]