摘要
目的探讨适龄期妇女复发性流产(recurrent spontaneous abortion,RSA)与叶酸代谢基因亚甲基四氢叶酸还原酶(methylene Tetrahydrofolate Reductase,MTHFR)、纤溶酶原激活物抑制物1(plasminogen activator inhibitor-1,PAI-1)基因多态性的相关性及不同MTHFR基因型患者服用不同剂量叶酸后血清浓度的差别。方法采用前瞻性病例对照研究,选取2019年1月至2021年6月安徽省宣城市人民医院妇产科就诊的110例既往有RSA史、此次妊娠≤12周的孕妇纳入RSA组,无流产史者100例纳入对照组。分别抽取静脉血后,检测受试者MTHFR基因C677T位点、A1298C位点及PAI-1位点多态性及血清叶酸含量。呈正态分布的计量资料组间的比较采用t检验,计数资料采用χ^(2)检验,采用Logistic回归分析进行多因素分析。结果RSA组和对照组受试者MTHFR C677T[CC:21.62%(24/111)与51.00%(51/100),TT:28.83%(32/111)与12%(12/100)]及等位基因[C:46.40%(103/222)与69.50%(139/200),T:53.60%(119/222)与30.50%(61/200)]、PAI-1基因型[5G5G:22.52%(25/111)与48.00%(48/100),4G4G:44.14%(49/111)与16.00%(16/100)]及等位基因[5G:39.19%(87/222)与66.00%(132/200),4G:60.81%(135/222)与34.00%(68/200)]频率分布比较,差异均有统计学意义(χ^(2)分别为21.82、22.96及23.51、30.30;P值均<0.001)。经Logistic分析MTHFR C677T(OR=0.477,95%CI 0.303~0.750)、PAI-1基因型(OR=0.451,95%CI 0.306~0.665)与RSA关系密切(P值分别为0.001、<0.001)。而两组受试者MTHFR A1298C基因型及等位基因差异无统计学意义(P值分别为0.270、0.149)。补充相同剂量叶酸时,两组叶酸血清浓度比较差异无统计学意义(0.4 mg叶酸时P=0.355;≥0.8 mg时P=0.786)。结论适龄期妇女RSA的发生可能与MTHFR C677T及PAI-1基因的突变有关,与MTHFR A1298C位点的突变可能无关。
Objective To investigate the association between recurrent spontaneous abortion(RSA)and methylenetetrahydrofolate reductase(MTHFR)and plasminogen activator inhibitor-1(PAI-1)gene polymorphism in pregnant women of appropriate age,and to observe the difference of the serum concentration of patients with different MTHFR genotypes after taking different does of folic acid.Methods A prospective case-control study was conducted,one handred and eleven pregnant women with a history of unexplained RSA and gestation less than 12 weeks who visited the Department of Obstetrics and Gynecology of Xuancheng People's Hospital of Anhui Province from January 2019 to June 2021 were enrolled into the RSA group,and 100 normal women of childbearing age in the same area with no history of abortion were included in the control group.After venous blood was extracted,the polymorphisms of MTHFR gene C677T,A1298C PAI-1 and the serum folic acid concentration were detected.The comparison between the measurement data groups with normal distribution adopts t-test,and the counting data adopts t-testχ^(2) test,Logistic regression analysis was used for multivariate analysis.Results The genotype and allele of MTHFR C677T(CC:21.62%(24/111)and 51.00%(51/100),TT:28.83%(32/111)and 12%(12/100))and allele(C:46.40%(103/222)and 69.50%(139/200),T:53.60%(119/222)and 30.50%(61/200))and PAI-1(5G5G:22.52%(25/111)and 48.00%(48/100),4G4G:44.14%(49/111)and 16.00%(16/100);5G:39.19%(87/222)and 66.00%(132/200),4G:60.81%(135/222)and 34.00%(68/200))were significantly different(χ^(2) values were 21.82,22.96 and 23.51,30.30;all P<0.001)between the RSA group and control group.Logistic analysis showed that MTHFR C677T(OR=0.477,95%CI 0.303-0.750)and PAI-1 genotype(OR=0.451,95%CI 0.306-0.665)were closely related to recurrent abortion(P=0.001 and P<0.001).There were no significant differences in genotype and allele of MTHFR A1298C between the two groups(P values were 0.270 and 0.149).There was no significant difference in serum concentration of folic acid between the two gr
作者
张年宝
章云霞
赵梦岚
Zhang Nianbao;Zhang Yunxia;Zhao Menglan(Department of Pharmacy,Xuancheng People's Hospital,Anhui Province,Xuancheng 242000,China;Department of Gynecology and Obstetrics,Xuancheng People's Hospital,Anhui Province,Xuancheng 242000,China)
出处
《中国综合临床》
2022年第3期244-249,共6页
Clinical Medicine of China
基金
中华医学会临床药学分会吴阶平医学基金会科研专项基金课题(320.6750.19090-18)。
