同型半胱氨酸联合叶酸代谢相关酶基因在妊娠期高血压疾病中的临床价值  

Clinical value of homocysteine combined with folic acid metabolism-relatedenzyme gene in hypertensive disorder complicating pregnancy

作　　者：黄国平 徐梅[1] 陈月华[1] 王军 金华[2] 叶强 HUANG Guoping;XU Mei;CHEN Yuehua;WANG Jun;JIN Hua;YE Qiang(Department of Clinical Laboratory,Zigong Municipal Maternal and Child Health Care Hospital,Zigong,Sichuan 643000,China;Obstetrical Department,Zigong Municipal Maternal and Child Health Care Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]四川省自贡市妇幼保健院检验科,四川自贡643000 [2]四川省自贡市妇幼保健院产科,四川自贡643000

出　　处：《检验医学与临床》2023年第15期2201-2205,共5页Laboratory Medicine and Clinic

基　　金：四川省自贡市重点科技计划项目(2021ZC34)。

摘　　要：目的 研究同型半胱氨酸(Hcy)和叶酸代谢相关酶基因在妊娠期高血压疾病(HDP)中的价值。方法 将2021年11月至2022年8月自贡市妇幼保健院收治的65例HDP孕妇作为HDP组,选择同期来该院进行孕期健康体检的80例健康孕妇作为对照组。比较两组患者Hcy、胎盘生长因子(PLGF)、肝功能、肾功能、24小时尿蛋白定量(24 h UP)、凝血功能、血栓弹力图、血脂水平及叶酸代谢相关酶基因的多态性。结果 与对照组比较,HDP组Hcy、碱性磷酸酶(ALP)、凝血酶时间(TT)水平显著升高(P<0.05),而PLGF水平显著降低(P<0.05),血栓弹力图中两侧曲线的最宽距离(MA)增大(P<0.05)。HDP组孕妇叶酸代谢障碍风险比例显著高于对照组,未发现风险比例显著低于对照组,差异均有统计学意义(P<0.05)。HDP孕妇叶酸代谢障碍风险组的Hcy、24 h UP及尿酸(UA)水平显著高于未发现风险组(P<0.05),而PLGF水平显著低于未发现风险组(P<0.05)。分析MTHFR677C>T基因型分布发现,HDP组携带T等位基因的频率(43.1%)高于对照组(25.6%),差异有统计学意义(P<0.05);分析MTHFR1298A>C、MTRR66A>G基因型分布发现,HDP组携带C等位基因的频率及携带G基因的频率与对照组比较,差异均无统计学意义(P>0.05)。Spearman相关分析结果显示,Hcy水平与PLGF水平呈显著负相关(r=-0.543,P<0.05)。结论 叶酸代谢障碍及高Hcy水平与HDP密切相关,可为该病未来临床诊治提供重要参考依据。Objective To investigate the value of homocysteine(Hcy)and folic acid metabolism-related enzyme gene in hypertensive disorder complicating pregnancy(HDP).Methods Sixty-five patients with HDP admitted to Zigong Municipal Maternal and Child Health Care Hospital from November 2021 to August 2022 were selected as the HDP group,and 80 healthy pregnant women who came to the hospital for pregnancy examination during the same period were selected as the control group.The levels of Hcy,placental growth factor(PLGF),liver function,renal function,24-hour urine protein(24 h UP),blood conventional coagulation,thrombelastography,blood lipids and polymorphisms in genes for enzymes related to folate metabolism were compared between the two groups.Results Compared with the control group,the levels of Hcy,uric acid,alkaline phosphatase,thrombin time in the HDP group increased significantly(P<0.05),while the level of PLGF decreased significantly(P<0.05),and the maximum amplitued(MA)between the curves on either side of the thromboelastogram increased(P<0.05).The risk ratio of folic acid metabolism disorder in the HDP group was significantly higher than that in the control group,while the risk-free ratio in the HDP group was significantly lower than that in the control group,and the differences had statistical significance(P<0.05).In the HDP group,the levels of Hcy,24 h UP and UA in the risky group of folic acid metabolism disorder were significantly higher than those in the undetected risky group(P<0.05),while the levels of PLGF was significantly lower than that in the undetected risky group(P<0.05).The analysis of the distribution of MTHFR677C>T genotypes showed that the frequency of carrying T allele in the HDP group(43.1%)was higher than that in the control group(25.6%),and the difference was statistically significant(P<0.05),while the analysis of the distribution of MTHFR1298A>C and MTRR66A>G genotypes found that the differences on the frequency of carrying C allele and the frequency of carrying G allele between the HDP group an

关 键 词：同型半胱氨酸 叶酸代谢相关酶基因 妊娠期高血压疾病 

分 类 号：R714.246[医药卫生—妇产科学]