子痫前期孕妇孕早期、孕中期血清25(OH)D_3水平变化及其意义
朱飞龙;陈慧芬;张军;吴瑛婷;刘媛;
摘要(Abstract):
目的观察子痫前期(PE)孕妇不同孕期血清25-羟基维生素D[25(OH)D_3]水平变化,并探讨其意义。方法选取重度子痫前期(SPE)孕妇335例(重度组)、非重度子痫前期孕妇127例(非重度组),另选500例健康体检孕妇作对照(对照组),比较各组孕早期(14周)、孕中期(28周)血清25(OH)D_3水平及25(OH)D_3缺乏情况。结果与对照组比较,重度组孕早期、孕中期25(OH)D_3水平及非重度组孕中期25(OH)D_3水平降低(P均<0.05);与同组孕早期比较,重度组孕中期25(OH)D_3水平升高,非重度组孕中期25(OH)D_3水平降低(P均<0.05)。与对照组比较,重度组和非重度组孕早期、孕中期25(OH)D_3缺乏率高(P均<0.05)。结论 SPE孕妇孕早期、孕中期血清25(OH)D_3水平降低,非重度子痫前期孕妇孕中期血清25(OH)D_3水平降低,血清25(OH)D_3水平与PE的发生发展密切相关,其可作为PE病情严重程度的预测指标。
关键词(KeyWords): 子痫前期;重度子痫前期;维生素D;25-羟基维生素D
基金项目(Foundation):
作者(Author): 朱飞龙;陈慧芬;张军;吴瑛婷;刘媛;
Email:
DOI:
参考文献(References):
- [1]RANA S,LEMOINE E,GRANGER J P,et al.Preeclampsia:pathophysiology,challenges,and perspectives[J].Circ Res,2019,124(7):1094-1112.
- [2]DULEY L.The global impact of pre-eclampsia and eclampsia[J].Semin Perinatol,2009,33(3):130-137.
- [3]TAMBLYN J A,HEWISON M,WAGNER C L,et al.Immunological role of vitamin D at the maternal-fetal interface[J].J Endocrinol,2015,224(3):107-121.
- [4]AMAL A G,CAREY V J,DIVYA C,et al.The role of vitamin d in the transcriptional program of human pregnancy[J].PLo S One,2016,11(10):e0163832.
- [5]TAMBLYN J A,SUSARLA R,JENKINSON C,et al.Dysregulation of maternal and placental vitamin D metabolism in preeclampsia[J].Placenta,2017,50(2017):70-77.
- [6]WEI S Q,AUDIBERT F,HIDIROGLOU N,et al.Longitudinal vitamin D status in pregnancy and the risk of pre-eclampsia[J].BJOG,2012,119(7):832-839.
- [7]ROSS A C,MANSON J E,ABRAMS S A,et al.The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of medicine:what clinicians need to know[J].J Clin Endocrinol Metab,2011,96(1):53-58.
- [8]杨怡珂,漆洪波.美国妇产科医师学会(ACOG)“妊娠期高血压和子痫前期指南2019版”要点解读(第一部分)[J].中国实用妇科与产科杂志,2019,35(8):895-899.
- [9]KUEHN B M.Guideline for pregnancy weight gain offers targets for obese women[J].JAMA,2009,302(3):241-242.
- [10]AYDOGMUS S,KELEKCI S,AYDOGMUS H,et al.High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes[J].J Matern Fetal Neonatal Med,2015,28(15):1828-1832.
- [11]刘伟武.早发型重度子痫前期不同孕龄与母婴结局的关系研究[J].重庆医学,2014,43(8):932-934.
- [12]JEYABALAN A.Epidemiology of preeclampsia:impact of obesity[J].Nutr Rev,2013,71(Suppl1):18-25.
- [13]HOSSEIN-NEZHAD A,HOLICK M F.Vitamin D for health:a global perspective[J].Mayo Clin Proc,2013,88(7):720-755.
- [14]ZHAO X,FANG R,YU R Q,et al.Maternal Vitamin D status in the late second trimester and the risk of severe preeclampsia in Southeastern China[J].Nutrients,2017,9(2):138.
- [15]URRUTIA R P,THORP J M.Vitamin D in pregnancy:current concepts[J].Curr Opin Obstet Gynecol,2012,24(2):57-64.
- [16]李响,吴效科.维生素D与母体妊娠相关疾病关系的研究进展[J].国际妇产科学杂志,2019,46(6):632-635.
- [17]HYPPONEN E,CAVADINO A,WILLIAMS D,et al.Vitamin Dand pre-eclampsia:original data,systematic review and meta-analysis[J].Ann Nutr Metab,2013,63(4):331-340.
- [18]HOLLIS B W,JOHNSON D,HULSEY T C,et al.Vitamin D supplementation during pregnancy:double-blind,randomized clinical trial of safety and effectiveness[J].J Bone Miner Res,2011,26(10):2341-2357.