血清同型半胱氨酸、叶酸水平、凝血功能与先兆流产及其妊娠结局的关系

目的探讨血清同型半胱氨酸(Hcy)、叶酸水平、凝血功能与先兆流产的相关性及对妊娠结局的影响。方法收集2014年1月至2015年6月在我院妇产科确证为先兆流产的孕妇62例,纳入先兆流产组,另选择同期在本院妇产科进行产前检查的孕妇50例作为对照组,比较两组的血清Hcy、叶酸水平、凝血功能指标(Fbg及D二聚体)差异情况,分析各指标间的关系。并根据62例先兆流产患者的妊娠结局分为顺利分娩组(n=45)、难免流产组(n=12)和过期流产组(n=5),比较三组的血清Hcy、叶酸、Fbg、D二聚体水平。结果先兆流产组叶酸水平明显低于对照组(P0.05),Hcy、Fbg、D二聚体、血小板水平均明显高于对照组(P0.05)。血清Hcy与Fbg、D二聚体、血小板呈正相关性(P0.05),血清叶酸与Fbg、D-二聚体、血小板呈负相关性(P0.05),血清叶酸与Hcy呈负相关(P0.05)。过期流产组、难免流产组叶酸水平明显低于顺利分娩组(P0.05),Hcy、Fbg、D二聚体明显高于顺利分娩组(P0.05),过期流产组孕妇叶酸水平明显低于难免流产组,Hcy、Fbg、D二聚体明显高于难免流产组(P0.05)。结论联合检测Hcy、叶酸、Fbg、D二聚体及血小板水平,对预测孕妇是否存在先兆流产的发生风险及评估其妊娠结局有一定的临床价值。

Relationship Between Serum Homocysteine,Folic acid level,Coagulation Function and Threatened Abortion and Pregnancy Outcome

Objective To investigate the relationship between serum homocysteine ( Hcy ) , folic acid level,coagulation function and threatened abortion, its effect on pregnancy outcome. Methods 62 pregnant women,who were confirmated as threatened abortion in gynaecology and obstetrics department of our hospital from 2014 January to 2015 June,were collected and included into threatened abortion group. Meanwhile,50 pregnant women who were done antenatal examination in gynaecology and obstetrics department of our hospital were selected as control group. Serum Hcy,folic acid leve,coagulation function standard( Fbg and D-dimer) were analyzed and compared. According to the pregnancy outcomes,62 threatened abortion patients were divid-ed into smooth delivery group(n=45),inevitable abortion group(n=12)and expired abortion group(n=5), the serum Hcy,folic acid level,Fbg and D-dimer body were analyzed and compared. Results The folic acid, the Hcy,Fbg,D-dimer,platelet level in threatened abortion group was significantly lower than that in control group(P<0. 05). Serum Hcy was positively correlated with Fbg,D-dimer(P<0. 05). Serum folate was nega-tively correlated with Fbg,D-dimer(P<0. 05),Serum folate were negatively correlated Hcy(P<0. 05). The folic acid level in expired abortion group and inevitable abortion group was significantly lower than that in smooth delivery group(P<0. 05),and the Hcy,Fbg and D-dimer was obviously higher than that in smooth delivery group(P<0. 05). However,the folic acid level,the serum Hcy,Fbg and D-dimer of pregnant women in expired abortion group was significantly lower than that in inevitable abortion group(P<0. 05). Conclusion The combinated detection of serum Hcy,folic acid,Fbg,D-dimer and platelet has certain clinical value in predicting risk of occurrence for threatened abortion and assessment of pregnancy outcome in pregnant women.