接受主动免疫治疗的习惯性流产患者MTHFR基因C677T及A1298C突变与妊娠结局的相关性分析  

Correlation between MTHFR Gene C677T and A1298C Mutations and Pregnancy Outcome in Habitual Abortion Patients Receiving Active Immunotherapy

作　　者：沈娟[1] 舒晓芳[1] SHEN Juan;SHU Xiao-fang(Department of Obstetrics and Gynecology,Mianyang Central Hospital,Sichuan Mianyang 621000,China)

机构地区：[1]绵阳市中心医院妇产科,四川绵阳621000

出　　处：《现代检验医学杂志》2021年第3期32-37,42,共7页Journal of Modern Laboratory Medicine

摘　　要：目的研究主动免疫治疗习惯性流产女性的妊娠结局和亚甲基四氢叶酸还原酶(5,10-methylenetetrahydrofolate reductase,MTHFR)基因C677T及A1298C突变相关性。方法研究采取前瞻性研究,选取2017年1月~2019年2月绵阳市中心医院收治的120例习惯性流产患者作为研究对象,另选取正常妊娠人群120例作为对照组,习惯性流产患者均采取主动免疫进行治疗,比较观察组、对照组的MTHFR基因C677T和A1298C突变情况,以及MTHFR基因C677T和A1298C突变与主动免疫治疗后的妊娠结局的相关性,分析造成患者习惯性流产以及治疗后不良结局的危险因素。结果通过对患者的hardy-weinberg平衡检验分析,患者的MTHFR基因C677T位点基因多态性分布符合hardyweinberg平衡(χ^(2)=0.062,P=0.776),数据来自同一个样本群体。观察组与对照组的文化程度(χ^(2)=5.002,P=0.025)、孕次(χ^(2)=138.947,P=0.000)、丈夫饮酒(χ^(2)=12.343,P=0.000)、生殖道感染(χ^(2)=60.828,P=0.000)、孕期被动吸烟(χ^(2)=5.822,P=0.016)、噪音影响(χ^(2)=7.680,P=0.006)、噪音影响程度(χ^(2)=8.848,P=0.003)、C677T位点基因型(χ^(2)=7.651,P=0.022)及等位基因(χ^(2)=8.861,P=0.003)之间的差异均有统计学意义。通过多因素分析,文化程度为初中及以下、丈夫饮酒、生殖道感染、孕期被动吸烟、噪音影响以及噪音影响程度在6 h/d以上、C677T位点基因型为CT和TT,C677T位点等位基因为T均是造成患者习惯性流产的独立危险因素。经过免疫治疗后,随访一年,随访率为100%,无失访患者。所有患者均顺利妊娠,其中79例成功妊娠,41例再次流产。再次流产组以及成功妊娠组患者的文化程度(χ^(2)=33.812,P=0.000)、丈夫饮酒(χ^(2)=4.081,P=0.043)、生殖道感染(χ^(2)=7.667,P=0.006)、孕期被动吸烟(χ^(2)=10.142,P=0.001)、噪音影响(χ^(2)=4.321,P=0.038)、噪音影响程度(χ^(2)=6.421,P=0.011)、C677T位点基因型(χ^(2)=37.591,P=0.000)及等位基因(χ^(2)=8.032,P=0Objective To investigate the relationship between MTHFR C677T and A1298C mutations in women with habitual abortion receiving active immunotherapy.Methods In this prospective study,120 patients with habitual abortion in the Central Hospital of Mianyang City from January 2017 to February 2019 were selected as the research objects,and another 120 cases of normal pregnancy were selected as the control group.Patients with habitual abortion were treated with active immunization.MTHFR gene C677T and A1298C mutations were compared between the observation group and the control group,as well as the correlation between MTHFR gene C677T and A1298C mutations and pregnancy outcomes after active immunotherapy,and analysed the risk factors of habitual abortion and adverse outcomes after treatment.Results According to hardy Weinberg equilibrium test,the MTHFR gene C677T polymorphism distribution was in accordance with Hardy Weinberg equilibrium(χ^(2)=0.062,P=0.776),and the data were from the same sample group.The education level(χ^(2)=5.002,P=0.025),times of pregnancy(χ^(2)=138.947,P=0.000),husband drinking(χ^(2)=12.343,P=0.000),reproductive tract infection(χ^(2)=60.828,P=0.000),passive smoking during pregnancy(χ^(2)=5.822,P=0.025),noise impact(χ^(2)=7.680,P=0.006),degree of noise impact(χ^(2)=8.848,P=0.003),C677T locus genotype of observation group and control group were significantly different.There were statistically significant differences in gender(χ^(2)=7.651,P=0.022)and allele(χ^(2)=8.861,P=0.003);by multivariate analysis,education level was junior high school or below,husband drinking,reproductive tract infection,passive smoking during pregnancy,noise influence and noise in 6 after immunotherapy,the patients were followed up for 1 year,and the follow-up rate was 100%.All patients were pregnant successfully,including 79 cases of successful pregnancy,41 cases of abortion again.The education level(χ^(2)=33.812,P=0.000),husband drinking(χ^(2)=4.081,P=0.043),reproductive tract infection(χ^(2)=7.667,P=0.006),passiv

关 键 词：亚甲基四氢叶酸还原酶基因 C677T A1298C 主动免疫 习惯性流产 

分 类 号：R714.21[医药卫生—妇产科学] Q754[医药卫生—临床医学]