红细胞叶酸代谢对妊娠期糖尿病患者胎儿发育的影响研究  

Effect of Red Blood Cell Folic Acid Metabolism on Fetal Development in Patients with Gestational Diabetes Mellitus

作　　者：杨露 左建新[3] 

机构地区：[1]青岛大学医学部,山东 青岛 [2]康复大学青岛中心医院(青岛市中心医院)产科,山东 青岛 [3]青岛大学附属医院产科,山东 青岛

出　　处：《临床医学进展》2024年第6期309-318,共10页Advances in Clinical Medicine

摘　　要：近年来,妊娠期糖尿病(Gestational Diabetes Mellitus, GDM)作为一种典型的妊娠并发症,受到广泛关注。GDM不仅影响孕妇健康,更会对胎儿发育造成潜在风险。本研究探讨了红细胞叶酸代谢在GDM患者中的活性变化及其对胎儿发育的影响,以期为GDM患者的临床治疗提供新的干预策略。通过采集200例GDM孕妇和200例正常对照孕妇的血样,运用高效液相色谱(High Performance Liquid Chromatography, HPLC)技术和放射免疫分析(Radioimmunoassay, RIA)对红细胞中的叶酸水平及相关代谢酶活性进行了严格测定。研究显示,GDM患者群体中红细胞叶酸浓度显著低于正常对照组(P 2 = 0.624)。此外,运用逻辑回归发现叶酸代谢异常可作为预测GDM妊娠结局的独立风险因素(OR = 2.64, 95%CI: 1.57~4.42)。本研究强调了红细胞叶酸代谢在GDM患者胎儿生长发育中的关键作用,并且提示,通过叶酸的补充和代谢调控可能成为改善GDM孕妇妊娠结局的有效途径。针对这一发现,本文提出了若干实际可行的临床应用意见,希望为未来GDM患者的治疗与管理提供科学依据。In recent years, Gestational Diabetes Mellitus (GDM) has garnered widespread attention as a typical pregnancy complication. Not only does GDM affect maternal health, but it also poses potential risks to fetal development. This study explored the changes in erythrocyte folate metabolism in patients with GDM and its impact on fetal development, aiming to provide new intervention strategies for the clinical treatment of patients with GDM. Blood samples from 200 pregnant women with GDM and 200 healthy control pregnant women were collected, and the levels of folate in erythrocytes and the activity of related metabolic enzymes were rigorously measured using High Performance Liquid Chromatography (HPLC) techniques and radioimmunoassay (RIA). The study revealed that the concentration of erythrocyte folate in the GDM patient group was significantly lower than that of the normal control group (P 2 = 0.624). In addition, logistic regression identified folate metabolism abnormalities as an independent risk factor for predicting GDM pregnancy outcomes (OR = 2.64, 95%CI: 1.57~4.42). This study highlights the crucial role of erythrocyte folate metabolism in the fetal growth and development of GDM patients and suggests that folate supplementation and metabolic regulation may become effective ways to improve pregnancy outcomes for pregnant women with GDM. Based on these findings, this paper proposes a number of practical clinical application opinions, in the hope of providing a scientific basis for the future treatment and management of patients with GDM.

关 键 词：妊娠期糖尿病 红细胞叶酸代谢 胎儿发育 高效液相色谱 放射免疫分析 

分 类 号：R71[医药卫生—妇产科学]