妊娠神经管畸形孕妇血清叶酸与同型半胱氨酸水平分析

目的:比较妊娠早期神经管畸形(neural tube defects,NTDs)孕妇及正常孕妇血清叶酸和同型半胱氨酸(ho-mocysteine,Hcy)水平,分析两种物质的代谢水平与妊娠NTDs的关系。方法:采用病例对照研究方法,以NTDs高发的山西省5个县作为研究现场,选择9所医院收集研究对象,对所有研究对象采集肘静脉血5ml,检测其血清叶酸和Hcy水平,比较病例组和对照组血清叶酸和Hcy的差异。分别以对照组血清叶酸和Hcy浓度的第10和第90百分位数作为界值,划分为2个水平组,比较不同水平组NTDs的发病风险。结果:妊娠NTDs孕妇血清平均叶酸水平显著低于对照组(10.4nmol/Lvs14.7nmol/L,P0.05),同时血清Hcy高于对照组,差异无统计学意义。低叶酸水平孕妇妊娠NTDs的危险性显著增加(AOR=3.0,95%CI为1.2～7.7)。结论:孕期血清叶酸低水平是研究人群NTDs发生的危险因素。

Analyses of serum folic acid and homocysteine of pregnant women with NTDs

Objective:To compare the levels of serum folic acid (FA) and homocysteine (Hcy) between the women with NTDs and the normal controls in early pregnant phase,and analyze the influence of abnormal FA-associated metabolisms on the occurrence of NTDs.Methods:All subjects were recruited from 9 hospitals of 5 countries in Shanxi province,with a high prevalence of birth defects.5 ml cubital venous blood from every participant was obtained. The levels of FA and Hcy were analyzed and compared between NTDs-affected pregnancies and the controls.NTDs risk assessments were established in serum levels of FA and Hcy. Results:The FA level (10.40 nmol/l vs 14.7 nmol/l,P<0.01) of NTDs-affected pregnancies was significantly lower than that of the control group,and the Hcy level was higher than the control group. The risk of NTDs for the pregnant women with low FA level was significantly increased (AOR=3.0,95%CI:1.2~7.7)Conclusion:Low level of serum FA is the risk factors of NTDs in the population with high prevalence of NTDs.