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目的研究孕期母体钙代谢的特点及补钙对其影响。方法选择373例在我院行产前检查的单胎孕妇,孕20周始在正常饮食的基础上每日进食500ml牛奶或500mg柠檬酸钙,并于每晚再口服柠檬酸钙300mg至孕37周。首次产前检查及孕37周时测定血清钙离子(Ca++)、磷(P)、碱性磷酸酶(ALP)及尿钙(U-Ca)/肌酐(U-Cr)、羟脯氨酸(U-HOP)/肌酐(U-Cr)。根据首次产前检查时间将孕妇分为早孕组(≤12周),中孕组(13周~20周),服钙至37周者为晚孕组,晚孕组又按服钙情况分为按规定服钙组,未按规定服钙组,将同期到我院行孕前检查的同龄健康非孕妇女56名作为对照组进行分析。结果早孕组血清Ca++、ALP、U-HOP/U-Cr较对照组无明显改变(P>0.05),U-Ca/U-Cr较对照组明显降低,(P<0.05);中孕组血清Ca++、U-Ca/U-Cr较对照组及早孕组均明显降低(P<0.05);血清ALP、U-HOP/U-Cr较对照组及早孕组明显增高(P<0.05)。晚孕两组血清Ca++、U-Ca/U-Cr较对照组明显降低(P<0.05);血清ALP、U-HOP/U-Cr较对照组明显增高(P<0.05),Ca++、U-Ca/U-Cr较中孕期组无明显改变(P>0.05),血清ALP、U-HOP/U-Cr较中孕组明显增高(P<0.01),晚孕两组Ca++、U-Ca/U-Cr、ALP、U-HOP/U-Cr无显著性变化(P>0.05)。结论补钙应从孕中期开始,中国营养协会推荐的1200mg/日钙量是恰当的。
Objective To study the characteristics of maternal calcium metabolism during pregnancy and the effects of calcium supplementation on it. Methods A total of 373 pregnant women with prenatal examination in our hospital were enrolled in this study. 500 mg of milk or 500 mg of calcium citrate was consumed daily on the basis of a normal diet at 20 weeks’ gestation. 300 mg of calcium citrate was administered orally to pregnant 37 week. The first prenatal examination and the 37th week of pregnancy were measured serum Ca 2+, P, ALP and U-Ca / U-HOP) / creatinine (U-Cr). According to the time of the first prenatal examination, the pregnant women were divided into the first trimester group (≤12 weeks), the second trimester group (from13weeks to20weeks) According to the provisions of calcium group, not according to the provisions of calcium group, the same period to our hospital prenatal examination of 56 healthy non-pregnant women of same age as a control group for analysis. Results The levels of serum Ca ++, ALP and U-HOP / U-Cr in early pregnancy group were significantly lower than those in control group (P> 0.05) Ca ++, U-Ca / U-Cr were significantly lower than those in the control group and the early pregnancy group (P <0.05). The levels of serum ALP and U-HOP / U-Cr were significantly higher than those in the control group and the early pregnancy group (P <0.05). Compared with the control group, serum levels of Ca ++ and U-Ca / U-Cr in the second trimester of pregnancy were significantly lower (P <0.05), serum ALP and U-HOP / U- (P <0.05). The levels of serum ALP and U-HOP / U-Cr in Ca2 + and U-HOP / U-Cr groups were significantly higher than those in the second trimester group (P <0.01) U-Cr, ALP, U-HOP / U-Cr showed no significant change (P> 0.05). Conclusion Calcium should be from the second trimester, the Chinese Nutrition Association recommended 1200mg / day calcium is appropriate.