摘要
目的分析孕早期血清同型半胱氨酸(Hcy)水平和亚甲基四氢叶酸还原酶(methylenetetrahydrofolate reductase,MTHFR)基因多态性与子痫前期发生的关系。方法选择2018年1—5月在上海交通大学医学院附属国际和平妇幼保健院进行定期产前检查(简称产检)并分娩的孕妇128例,根据妊娠结局分为正常妊娠组(46例)、妊娠期高血压组(41例)、子痫前期组(41例)。比较各组孕妇的一般资料、孕早期血清学指标(Hcy、叶酸、维生素B 12),并检测其MTHFR基因rs1801133多态性。采用logistic回归分析检验子痫前期发生的危险因素。结果妊娠期高血压组、子痫前期组孕妇的年龄均显著大于正常妊娠组(P值均<0.05),BMI均显著高于正常妊娠组(P值均<0.05)。妊娠期高血压组、子痫前期组孕妇分娩孕周均显著短于正常妊娠组(P值均<0.05),新生儿体重均显著低于正常妊娠组(P值均<0.05)。子痫前期组孕妇血清Hcy水平均显著高于正常妊娠组和妊娠期高血压组(P值均<0.05)。3组间MTHFR基因rs1801133位点CC型(野生型)、CT型(杂合突变型)和TT型(纯和突变型)频率的差异均无统计学意义(P值均>0.05)。MTHFR基因rs1801133位点TT型孕妇的血清Hcy水平显著高于CC型和CT型患者(P值均<0.05)。logistic回归分析结果显示,孕早期血清Hcy水平升高是子痫前期发生的危险因素(OR=1.736,95%CI为1.141~2.622,P=0.010)。结论孕早期联合检测血清Hcy水平和MTHFR基因rs1801133多态性对预测子痫前期的发生具有重要意义。
Objective To analyze the relationship between homocysteine(Hcy),methylenetetrahydrofolate reductase(MTHFR)gene polymorphisms and the risk of preeclampsia in early pregnancy.Methods A total of 128 pregnant women who were routinely examined and delivered at our hospital from January 2018 to May 2018 were divided into normal pregnancy group(n=46),gestational hypertension group(n=41)and preeclampsia group(n=41).General information and serum indicators(Hcy,folic acid,vitamin B 12)in early pregnancy were collected.MTHFR rs1801133 genetic locus was detected.Homocysteine levels,rs1801133 mutation rate of MTHFR gene and their predictive value in preeclampsia were analyzed.Results The age and BMI of the gestational hypertension group and preeclampsia group were significantly higher than those of the normal pregnancy group(all P<0.05),while the gestational week and birthweight were significantly lower than those of the normal pregnancy group(all P<0.05).The levels of homocysteine in the early pregnancy in the preeclampsia group was significantly higher than that in the normal pregnancy group and gestational hypertension group(both P<0.05).There was no significant difference in the gene frequency of MTHFR rs1801133 CC-type,CT-type or TT-type(all P>0.05).Pregnant women with MTHFR rs1801133 TT homozygous mutant had significantly higher homocysteine levels in early pregnancy than those with CC type and CT type(both P<0.05).The logistic analysis showed that homocysteine levels in the first trimester was closely related to the risk of preeclampsia(OR=1.736,95%CI:1.141-2.622,P=0.010).Conclusion The combined detection of homocysteine levels and MTHFR rs1801133 gene polymorphism may help to predict the occurrence of preeclampsia in the first trimester.
作者
赵雪娅
陈莎
程蔚蔚
ZHAO Xueya;CHEN Sha;CHENG Weiwei(Department of Obstetrics,International Peace Maternity and Child Health Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)
出处
《上海医学》
CAS
2021年第6期416-420,共5页
Shanghai Medical Journal
基金
徐汇区市卫生和计划生育委员会重要疾病联合攻关项目(XHLHGG201805)
上海市卫生和计划生育委员会科研课题(20174Y0051)。
关键词
先兆子痫
高半胱氨酸
亚甲基四氢叶酸还原酶
多态现象
遗传
Preeclampsia
Homocysteine
Methylenetetrahydrofolate reductase
Gene polymorphism,inheritance
