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目的:探讨女性血清维生素D水平与早期自然流产的关系，并探索维生素D的作用机制。方法:本研究采用病例对照研究，选择2018年3月至2019年12月期间在桐庐县第一人民医院就诊的52例自然流产女性为研究组，因非意愿妊娠要求终止早期妊娠的患者50例作为对照组，育龄期非妊娠状态的女性体检者40例作为正常组，比较三组患者血清中维生素Dn 3、钙离子及甲状旁腺激素（PTH）的浓度，收集研究组和对照组人工流产后的绒毛组织及蜕膜组织，采用RT-PCR检测维生素D受体（VDR）及1a-羟酶（n CYP27B1基因编码）的mRNA表达量，以免疫组织化学法定位并检测两者的蛋白相对表达量。n 结果:研究组血清中维生素Dn 3浓度［12.4（10.1，17.2）n μg/L］均低于对照组［16.7（13.5，21.9） μg/Ln ， P0.05）。在蜕膜组织中，研究组的n VDR mRNA［0.871 3（0.668 6，1.085 7）］及蛋白表达量［3.0（2.5，4.0）］较对照组的 mRNA［1.102 7（0.897 7，1.357 1）］及蛋白表达量［4.5（3.5，5.5）］降低，且差异有统计学意义（n P=0.000 3；n P0.05）。在绒毛组织中，研究组和对照组相比，无论是n VDR还是n CYP27B1的mRNA及蛋白表达量差异均无统计学意义（n P>0.05）。n 结论:女性早期自然流产可能与低血清维生素D水平有关，低浓度维生素D主要通过下调蜕膜组织中的VDR表达导致早期自然流产的发生。“,”Objective:To investigate the relationship between serum vitamin D levels and early spontaneous abortion and to elucidate the mechanism of vitamin D in pregnancy.Methods:A total of 142 women at the Tonglu First People's Hospital in Zhejiang Province from March 2018 to December 2019 were enrolled in this case-control study. All the participants were divided into three groups and determined as experimental group (52 early spontaneous abortion women), control group (50 women who terminated an early pregnancy due to unintended pregnancy) and normal group (40 non-pregnancy women of childbearing age). The concentrations of serum vitamin Dn 3, calcium ion (Can 2+) and parathyroid hormone (PTH) were observed in the three groups. The chorionic villus and decidual tissues of experimental and control groups were firstly collected. Using RT-PCR, we identified the mRNA levels of vitamin D-related substances, the vitamin D receptor (VDR) and 1a-hydroxylase (encoded by n CYP27B1 gene). Furthermore, immunohistochemical method was used to detect the VDR and CYP27B1 expressions at protein level in two groups.n Results:The serum vitamin D concentration in experimental group [12.4(10.1,17.2) μg/L] was significantly lower than that of control group [16.7(13.5,21.9) μg/L, n P0.05). In the decidual tissues, expression levels ofn VDR mRNA [0.871 3(0.668 6,1.085 7)] and protein [3.0(2.5,4.0)] were decreased in experimental group compared with those in control group [1.102 7(0.897 7,1.357 1), 4.5(3.5,5.5)], and the difference was statistically significant (mRNAn P=0.000 3; protein n P0.05). In the chorionic villus, compared with control group, the differences in mRNA and protein expression levels of bothn VDR and n CYP27B1 were not statistically significant in experimental group (n P>0.05).n Conclusion:Early spontaneous abortion in women might be associated with low serum vitamin D levels. Importantly, vitamin D deficiency in pregnancy could contribute to the downregulation of VDR expression in decidual tissues, which leads to the early spontaneous abortion.