妊娠中晚期神经系统病症与血清VitB_(12)水平的相关性研究

目的:探讨妊娠中晚期神经系统病症与血清维生素B12(VitB12)水平的关系,观察补充VitB12治疗的临床效果。方法:采用病例对照法,将出现神经系统症状的妊娠中晚期妇女60例按症状不同程度分为症状明显组(Ⅰ组)和症状轻微组(Ⅱ组),30例正常孕妇做为对照组(Ⅲ组),采用化学发光法进行血清VitB12水平的测定,Ⅰ组、Ⅱ组分别给予肌内注射及口服VitB12治疗后,检测血清VitB12水平,观察其变化情况并做疗效分析。结果:Ⅰ组、Ⅱ组血清VitB12水平分别为98.7±37.8pmol/L和158.9±46.8pmol/L,明显低于Ⅲ组334.4±109.3pmol/L,差异均有统计学意义(P<0.05);治疗后Ⅰ组、Ⅱ组血清VitB12水平分别为289.7±44.4pmol/L和212.5±48.1pmol/L,与治疗前比较差异均有统计学意义(P<0.05);Ⅰ、Ⅱ组分别有86.67%、63.33%神经系统症状较治疗前明显缓解,两组有效率差异有统计学意义(P<0.05)。结论:妊娠中晚期神经系统症状的发生与血清VitB12水平降低有关。必要的VitB12治疗对改善妊娠中晚期VitB12缺乏症有良好的临床疗效。

Study on the Correlation of Neurological Disease and Serum Vitamin B12 Concentration in the Second and Third Trimester

Objective:To explore the correlation of neurological disease and serum vitamin B12 concentrations in the second and third trimester in order to find out the clinical effect of vitamin B12 supplement. Methods: A case control study was conducted. Sixty pregnant women with severe and slight symptom of neurological dysfunction were allocated to group Ⅰand group Ⅱ respectively according to the severity of symptom. And the control group (group Ⅲ) included 30 normal pregnant women. Women in group Ⅰand group Ⅱreceived vitamin B12 intramuscularly and orally respectively. The concentrations of serum vitamin B12 were determined by chemiluminescence immunoassay. Results: The concentrations of vitamin B12 were 98.7±37.8 pmol/L and 158.9±46.8 pmol/L in groupⅠand group Ⅱrespectively,significantly lower than that in group Ⅲ (334.4±109.3 pmol/L,P<0.05). The concentration of vitamin B12 in patients after treatment were 289.7±44.4 pmol/L and 212.5±48.1 pmol/L in groupⅠand groupⅡrespectively. In these two groups,statistically significant differences were found before and after treatment ( P <0.05). As to the neurological symptom,86.67% patients in group Ⅰ and 63.33% in group Ⅱ were relieved. Significant difference was found between groupⅠand groupⅡ. Conclusion: The occurrence of neurological symptom could be related to the decrease of serum vitamin B12 concentration in the second and third trimester. Vitamin B12 supplement is necessary for the treatment of Vitamin B12 deficiency in the second and third trimester.