复发性自然流产患者Hcy水平及MTHFR基因多态性与中医肾虚血瘀型相关研究  

Relationship between Hcy Levels and the Polymorphism of MTHFR Gene with TCM Type of Kidney Deficiency and Blood Stasis in Recurrent Spontaneous Abortion Patients

作　　者：王晨晔 丁彩飞 杨欣 万凌屹 

机构地区：[1]浙江省中西结合医院生殖医学科,杭州310003

出　　处：《浙江中西医结合杂志》2017年第6期470-473,共4页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：浙江省中西医结合医院科研基金资助No.hhyn201501

摘　　要：目的探讨复发性自然流产(RSA)患者同型半胱氨酸(Hcy)水平及MTHFR50名基因突变率与中医肾虚血瘀型相互关系。方法检测50例复发性自然流产患者(RSA观察组)、50名无不良妊娠史的育龄期妇女(健康对照组)血浆Hcy水平、MTHFR基因,中医辨证分为肾虚血瘀型及非肾虚血瘀型。结果 RSA观察组MTHFR基因型频率纯合突变型TT(24/50,48%),显著高于健康对照组(9/50,18%);杂合子型CT(22/50,44%)与健康对照组(24/50,48%)比较,差异无统计学意义(P>0.05);健康对照组野生型CC(17/50,34%)显著高于RSA观察组(4/50,8%)(P<0.01);RSA观察组MTHFR基因TT型:肾虚血瘀型(13例,26%)>非肾虚血瘀型(5例,10%)。复发性自然流产患者MTHFR基因TT型相关性Logistic回归分析显示相关因素中,证型肾虚血瘀型对复发性自然流产患者MTHFR基因TT型影响最大,其他依次为年龄、流产次数。RSA观察组患者血浆Hcy(7.32±0.79)μmol/L,显著高于健康对照组的(6.10±0.89)μmol/L(P<0.05);RSA观察组患者肾虚血瘀证组Hcy水平显著高于非肾虚血瘀型[(7.89±0.76)μmol/L比(6.13±0.96)μmol/L,P<0.05]。结论 MTHFR C677T纯合子突变TT型、Hcy水平增高与复发性流产有明确的相关关系,且与中医肾虚血瘀有相关性。Objective To investigate the relationship between homocysteine （Hcy） level and MTHFR mutation rate with TCM Kidney Deficiency and Blood Stasis Type in natural recurrent spontaneous abortion patients. Methods The level of Hcy and MTHFR gene in 50 recurrent spontaneous abortion patients （observation group） and 50 child-bearing-age women without adverse pregnancy history （control group） were detected. TCM differentiation included kidney deficiency and blood stasis type and non-kidney deficiency and blood stasis type. Results Twen- ty-four out of 50 patients in observation group and 9 women in control group had the TY genotype of MTHFR C677T（48% vs 18%, P〈0.05）; 22 patients in observation group and 24 women in control group had the CT genotype （44% vs 48%, P〉0.05）; 17 women in control group and 4 patients in observation group had the CC genotype （34% vs 8%, P〈0.05）. Logistic regression analysis result showed that the TF genotype of MTHFR gene played the most important role in the TCM differentiation of kidney deficiency and blood stasis type and non-kidney deficien- cy and blood stasis type in recurrent spontaneous abortion patients, followed by age and the number of abortions. The serum level of Hey in observation group was significantly higher than that in control group （7.32±0.79μMol/L vs 6.10±0.89μmol/L, P〈0.05）; in observation group, the Hcy level of patients with kidney deficiency and blood stasis type was significantly higher than that of patients with non-kidney deficiency and blood stasis type （7.89±0.76μmol/L vs 6.13±0.96μmol/L, P〈0.05）. Conclusion MTHFR C677T TF homozygous mutant types, the increase of Hcy level and recurrent miscarriage have a clear correlation and are also correlated with the TCM Kidney Blood.

关 键 词：复发性自然流产 同型半胱氨酸 亚甲基四氢叶酸还原酶 肾虚血瘀 

分 类 号：R271.9[医药卫生—中西医结合]