孕期妇女全血5种微量元素的测定

摘要:目的　了解不同孕期妇女外周血铜、锌、钙、镁、铁元素水平的变化。方法　选取2012年7月-2014年6月在我院进行孕前、妊娠及产后体检的20～35岁健康女性为研究对象，选择孕前样本100例，妊娠样本900例（4周为一孕期，每孕期100例），产后样本收集69例，以原子吸收光谱法测定外周血5种元素含量。结果　血铜水平与孕期正相关（r＝0.388，P＜0.01），产后下降接近孕前。孕前、孕4～8周及产后血铜水平显著低于其他孕期（-462.09＜H＜-257.67，P＜0.001）。血锌水平孕20周前与孕期负相关（r＝-0.218，P＜0.01），孕20周后与孕期正相关（r＝0.106，P＜0.01）；血锌水平在产后显著高于孕前～孕32周各期（-373.42＜H＜-193.76，P值介于0.000～0.003），在孕37～40周显著高于孕4～24周各期（-278.45＜H＜-155.18，P值介于0.000～0.021），在孕33～36周显著高于孕9～24周各期（-226.90＜H＜-149.10，P值介于0.000～0.035），在孕前（H分别为160.68，155.39，P值分别为0.013，0.020）及孕29～32周（H分别为-179.66，-174.37，P值分别为0.002， 0.004）高于孕13～20周各期。血镁水平与孕期负相关（r＝-0.165，P＜0.01），产后恢复至孕前。血镁水平在孕前（156.69＜H＜181.90，P值介于0.002～0.018）、孕4～8周（151.22＜H＜176.43，P值介于0.003～0.029）及产后-211.75＜H＜-186.54，P值介于0.001～0.006）高于孕37～40周及孕17～32周各期，在产后高于孕33～36周（H＝-167.22，P＝0.03）。血铁水平与孕期负相关（r＝-0.264，P＜0.01），孕33周后逐步恢复。血铁水平在孕前高于孕9～40周各期（163.42＜H＜322.71，P值介于0.000～0.010），在孕4～8周高于孕17～40周各期（170.15＜H＜228.42，P值介于0.000～0.005），在孕9～12周高于孕21～28周各期（148.96＜H＜159.29，P值介于0.036～0.015），在产后分别高于孕21～28周（-187.16＜H＜-176.83，P值介于0.006～0.014＜0.05）及孕33～36周（H＝-166.03，P＝0.032）。不同孕期妇女血钙水平无统计学差异（P＝0.098）。结论　血铜在孕期增高，血镁水平在孕17～32周达到最低，血铁在21～36周达到最低，血锌在孕20周达到最低。妊娠期微量元素的补充应根据该元素在孕期的变化规律有所侧重。

Five essential elements in the blood of pregnant women

Abstract: Objective To investigate the levels of five essential elements (copper, zinc, calcium, magnesium and iron) in different stages of pregnancy. Methods 100 progestational samples, 900 gestational samples (100 samples per 4 gestational weeks) and 69 postpartum samples were collected. These samples were taken from the healthy women who went to Henan maternity and child care centers and took progestation, gestation or puerperium health examination. Based on the method of atomic absorption spectrometry, the levels of the five elements in blood were evaluated. Results The copper level was positively correlated to pregnancy (r=0.388, P<0.01) and fell to progestational level postpartum. During the 3 stages of progestation, gestational age 4 to 8 weeks and puerperium, the copper levels were lower than that at gestational age 9 to 40 weeks (H -462.09~-257.67, P=0.000<0.01).The zinc level was negatively correlated to the time range of pregnancy in the first 20 weeks of gestation (r=-0.218, P<0.01), and the correlation changed to positive afterwards (r=0.106, P<0.01). After childbirth, zinc level was higher than that of the first 32 weeks after progestation (H -373.42~-193.76, P 0.000~0.003<0.01). At 37 to 40 weeks after progestation, the zinc level was higher than that at 4 to 24 weeks (H -278.45~-155.18, P 0.000~0.021<0.05). At gestational age 33 to 36 weeks, the zinc level was higher than the levels of gestational age 9 to 24 weeks (H -226.90~-149.10, P 0.000~0.035<0.05). For the timing of immediately after progestation (H 160.68, 155.39; P 0.013, 0.020<0.05) and gestational age 29 to 32 weeks (H -179.66, -174.37; P 0.002, 0.004<0.01), the zinc levels were both higher than that at gestational age 13 to 20 weeks. The magnesium level was negatively correlated to the length of pregnancy (r=-0.165, P<0.01) and returned to progestational level postpartum. All the magnesium levels at progestation (H 156.69~181.90, P 0.018~0.002<0.05), gestational age 4 to 8 weeks (H 151.22~176.43, P 0.029~0.003<0.05) and puerperium (H -211.75~-186.54, P 0.006~0.001<0.01) were higher than that at gestational age 17 to 32 weeks and 37 to 40 weeks. After childbirth, the magnesium level was higher than that at gestational age 33 to 36 weeks (H=-167.22, P=0.03<0.05). The iron level was negatively correlated to the length of pregnancy (r=-0.264, P<0.01) and the trend was inverted 33 weeks after progestation. The iron level of progestation was higher than the levels of gestational age 9 to 40 weeks (H 163.42~322.71, P 0.010~0.000<0.05). The iron level of 4 to 8 gestational weeks was higher than the levels of gestational age 17 to 40 weeks (H 170.15~228.42, P 0.005~0.000<0.01). The iron level of gestational week 9 to 12 was higher than that from 21 to 28 weeks (H 148.96~159.29, P 0.036~0.015<0.05). After childbirth, the iron level was higher than that of gestational week from 21 to 28 (H -187.16~-176.83, P 0.014~0.006<0.05) and 33 to 36 week (H=-166.03, P=0.032<0.05). The calcium level was not significantly different among different pregnant periods (P=0.098). Conclusion The copper level kept increasing throughout the gestation period. The lowest magnesium level appeared at gestational age 17 to 32 weeks and lowest iron level was during gestational age 21 to 36 weeks. The lowest zinc level appeared at gestational week 20. Thus we should replenish these elements according to specific situation.