妊娠晚期血清同型半胱氨酸水平与胎儿生长受限的相关性研究

[摘要] 目的 通过检测存在胎儿生长受限孕妇的妊娠晚期血清同型半胱氨酸（homocysteine，HCY）水平，研究其与胎儿生长受限的相关性。 方法 选择2015年3月1日～8月31日期间，在我院住院分娩的63例存在胎儿生长受限的孕妇作为观察组（胎儿生长受限组），并随机抽取该院同期健康的单胎妊娠晚期孕妇90例作为对照组，对比两组血清HCY水平和临床特征。 结果 胎儿生长受限组和对照组在孕妇年龄、孕次、产次方面差异无统计学意义（P>0.05）；两组在分娩孕周、新生儿出生体重、孕妇HCY水平的差异存在统计学意义（P<0.05）。将胎儿生长受限组按照分娩孕周分为早产组和足月产组后，可见早产组与对照组的HCY水平差异更为显著（P<0.05）。所有研究对象按照HCY水平分组后可见HCY正常组和异常组的新生儿出生体重的差异也有统计学意义（P<0.05）。结论 妊娠晚期孕妇血清HCY水平与胎儿生长受限存在相关性。 
　　[关键词] 同型半胱氨酸；胎儿生长受限；出生体重；妊娠 
　　[中图分类号] R714.2 [文献标识码] A [文章编号] 1673-9701（2016）06-0001-03 
　　Correlation of serum homocysteine levels with fetal growth restriction in the third trimester of pregnancy 
　　LI Maoyu SHEN Guosong SHAO Huifen SHAO Jie 
　　Department of Obstetrics， Huzhou Women’s and Children’s Hospital in Zhejiang Province， Huzhou 313000， China 
　　[Abstract] Objective To study its correlation with fetal growth restriction by detecting serum homocysteine（HCY） levels of pregnant women with fetal growth restriction in the third trimester of pregnancy. Methods A total of 63 cases of fetal growth restriction women were recruited as the observation group（FGR group） in our hospital from March 1 to August 31，2015. And randomly selected 90 cases of pregnant women as the control group in the same period. The levels of serum homocysteine and clinical characteristics were compared between the two groups. Results There were no significant differences of maternal age， pregnancies and parities between fetal growth restriction group and control group（P>0.05）. But the gestational age， birth weight and homocysteine levels had significantly differences between the two groups（P<0.05）. And the difference of HCY levels between the preterm group with fetal growth restriction and control group was more significant（P<0.05）. When all the research objects were grouped according to the HCY level， and the difference of birth weight between the HCY normal group and the abnormal group was statistically significant （P<0.05）. Conclusion Serum HCY levels of pregnant women are tightly related to fetal growth restriction， and it requires more clinical attention. 
　　[Key words] Homocysteine； Fetal growth restriction； Birth weight； Pregnancy
　　胎儿生长受限（fetal growth restriction，FGR）为生长潜力低下的小于孕龄儿。与同孕龄出生的正常体重儿比较，胎儿生长受限者更易发生胎儿窘迫、胎死宫内，并且其出生后新生儿死亡率和并发症发生率较正常体重儿也明显增高。影响胎儿生长的因素包括母亲的营养状况、胎盘的转运功能以及遗传因素等，但是其他可能影响到胎儿生长受限的因素不可忽视。 
　　研究发现，同型半胱氨酸（homocysteine，HCY）水平的升高与许多妊娠相关的疾病具有密切联系。已经证实HCY的浓度升高与自然流产、子痫前期、未足月胎膜早破及胎儿神经管缺陷等发病率[1，2]上升有关。本文通过对存在胎儿生长受限的妊娠晚期妇女进行血清HCY水平检测，并追踪至分娩，记录分娩后的新生儿体重，评价HCY水平与FGR的相关性。