孕期微量元素对先天性心脏病的影响

目的  研究妊娠期母体全血微量元素对先天性心脏病（CHD）的影响。方法  选取2013年1月-2014年12月在该院引产或分娩CHD患儿的母亲410例为研究组，同期在该院引产或分娩的正常母亲100例为对照组，采用原子吸收分光光度法检测研究组及对照组妇女全血微量元素铜、锌、钙、镁及铁的含量，比较研究组及对照组微量元素值。结果  微量元素缺乏率为18.05%（74/410）。微量元素缺乏以铁、锌元素为主，铁缺乏率为12.20%（50/410），锌缺乏率为5.61%（23/410），贫血率为14.88%（61/410）；对两组各元素进行比较，锌、钙、镁、铁及血红蛋白含量比较，差异有统计学意义（P <0.05）。对锌、铁元素缺乏情况进行比较，铁元素缺乏比较，差异有统计学意义（P <0.05）。分别将贫血组、缺铁组、缺锌组与研究组及对照组进行比较，发现各组镁、铁元素和血红蛋白含量较研究组与对照组低，且差异有统计学意义（P =0.000）。比较单纯先心组与复杂先心组各微量元素含量，发现复杂先心组各微量元素含量均较单纯组低，但差异无统计学意义（P >0.05）。对贫血组、缺铁组及缺锌组3组先心类型进行统计，以室间隔缺损和动脉导管未闭最常见，各CHD类型构成比情况在3组间差异无统计学意义（χ2=8.304，P >0.05）。结论  深圳市妊娠CHD患儿的母体微量元素缺乏以铁和锌为主，微量元素的吸收和利用可相互影响，应注意合理补充。

Effect of trace elements of pregnant women on congenital heart diseases of their children

Objective To explore the effects of trace elements in whole blood on congenital heart diseases (CHD) among 410 pregnant women in Shenzhen. Methods A total of 410 women whose offspring were diagnosed with CHD were enrolled into research group and compaered with 100 women with normal offspring  (control group) on the intake of periconceptional nutrition. All the selected women delivered from Jan. 2013 to Dec. 2014. The content of trace elements in whole blood of these women were determined by atomic absorption spectrophotometry (AAS), and the results were analyzed by comparing the values of the experimental group and the control group. Results The lack rate of trace elements in the pregnant women was 18.05%, that of iron in pregnancy was the highest (up to 12.19%), that of zinc was the second (up to 5.61%). The rate of anemia was 14.88%. Except for Cu, there were significant differences in the trace elaments between the research group and the control group (P < 0.05). The content of Mg, Fe and Hb in the anemia group, the iron-defficiency group and zinc-defficiency group was significantly lower than that of the research group and the control group (P = 0.000). The content of the trace elements was less in the complex CHD group without significant difference from that in the simple CHD group (P > 0.05). The most common cardiovascular malformations were ventricular septal defect and patent ductus arteriosus in the anemia group, the iron-defficiency group and the zinc-defficiency group; but the constituent ratios had no significant differences among the threegroups (χ2 = 8.304, P > 0.05). Conclusions The deficiency of iron and zinc is the most common in pregnant women with CHD fetus, they may have mutual effect with other trace elements, so the pregnant women should have reasonable supplement.