不同孕期孕妇血清叶酸、维生素B12与铁蛋白表达水平及其意义  

The expression and significance of serum levels of folic acid,vitamin B12 and ferritin in pregnant women in different pregnancy periods

作　　者：刘春艳 李娟[2] Liu Chunyan;Li Juan(Department of Obstetrics,Binzhou Second People′s Hospital,Binzhou 256800,Shandong Province,China;Shandong University,Jinan 250021,Shandong Province,China)

机构地区：[1]滨州市第二人民医院产科,山东256800 [2]山东大学,济南250021

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第6期671-678,共8页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(81503298)。

摘　　要：目的探讨孕妇血清叶酸、维生素B12、铁蛋白水平(以下简称为“贫血3项指标”)及其意义。方法选择2017年1月至2019年1月,于滨州市第二人民医院进行产前检查并分娩的早、中、晚孕期孕妇,以及进行健康体检的育龄期非妊娠女性各130例为研究对象,分别纳入早、中、晚孕期组及对照组,并对各组受试者进行贫血3项指标检测。采用单因素方差分析及SNK-q法,对4组受试者贫血3项指标检测结果分别进行总体及两两比较;采用χ^(2)检验,对早、中、晚孕期组孕妇贫血3项指标异常(叶酸/维生素B12/铁蛋白这3种物质之一缺乏)、贫血发生率及妊娠并发症发生情况分别进行总体及两两比较;采用独立样本t检验,分别对不同孕期组贫血3项指标异常与正常孕妇分娩新生儿出生时生长发育指标进行比较。本研究遵循的程序符合2013年新修订的《世界医学协会赫尔辛基宣言》要求,所有受试者签署临床研究知情同意书。结果①早孕期组与对照组受试者贫血3项指标比较,差异均无统计学意义(P>0.05)。中、晚孕期组受试者血清叶酸、维生素B12及铁蛋白水平分别为(8.8±2.4)nmol/L、(238.2±103.8)pmol/L及(41.5±10.3)μg/L,(6.3±1.2)nmol/L、(134.2±23.5)pmol/L及(15.7±6.8)μg/L,均分别低于早孕期组和对照组的(12.9±3.4)nmol/L、(353.7±122.9)pmol/L及(77.7±15.1)μg/L,(13.6±3.8)nmol/L、(376.9±128.7)pmol/L及(80.3±16.3)μg/L,并且差异均有统计学意义(中孕期组vs早孕期组:q=16.226、12.702、32.478,均为P<0.001;中孕期组vs对照组:q=18.997、15.254、34.810,均为P<0.001;晚孕期组vs早孕期组:q=26.120、24.140、55.625,均为P<0.001;晚孕期组vs对照组:q=28.891、26.691、57.957,均为P<0.001)。随着孕龄增加,孕妇贫血3项指标逐渐下降,并且差异均有统计学意义(P<0.05)。②晚孕期组孕妇贫血3项指标异常发生率、叶酸缺乏性巨幼细胞性贫血及缺铁性贫血发生率,以及贫血总发�Objective To investigate serum levels of folic acid,vitamin B12 and ferritin(this study is referred to as"3 parameters of anemia")of pregnant women and their significances.Methods There were 130 pregnant women in early,middle and late pregnancy,respectively,who underwent prenatal examination and childbirth in Binzhou Second People′s Hospital from January 2017 to January 2019,and 130 non ∑-pregnant women of childbearing age who underwent physical examination in the same hospital at the same time,were selected as research subjects.According to gestational age and pregnant or not,they were divided into early pregnancy group,middle pregnancy group,late pregnancy group and control group,respectively.These 3 parameters of anemia of all subjects were measured.These parameters of anemia among four groups were overall compared by one-way ANOVA and further compared by SNK-q method.Chi-square test was used to make overall and pairwise comparison of incidence of 3 parameters of anemia abnormal(deficiency among one of three substances of folic acid,vitamin B12 and ferritin),anemia and complications during pregnancy among pregnant women in early,middle and late pregnancy group.Independent-samples t test was used to compare neonatal growth and development indexes at birth between neonates of pregnant women with 3 parameters of anemia abnormal and normal in different pregnancy group,respectively;The procedure followed in this study was in accordance with the World Medical Association Declaration of Helsinki revised in 2013,and all subjects signed the informed consent forms for clinical research.Results①There were no significant differences in 3 parameters of anemia of subjects between early pregnancy group and control group(P>0.05).The serum levels of folic acid,vitamin B12 and ferritin in middle pregnancy group and late pregnancy group were(8.8±2.4)nmol/L,(238.2±103.8)pmol/L and(41.5±10.3)μg/L,and(6.3±1.2)nmol/L,(134.2±23.5)pmol/L and(15.7±6.8)μg/L,respectively,which were lower than those of(12.9±3.4)nmol/L,(353.

关 键 词：妊娠三月期 叶酸 维生素B12 铁蛋白质类 贫血 妊娠并发症 孕妇 胎儿 

分 类 号：R71[医药卫生—妇产科学]