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目的探讨妇女血浆中同型半胱氨酸(Hcy)、叶酸(FA)及维生素B12(Vit B_(12))与不良妊娠的关系。方法收集不良妊娠结局孕妇601例,正常妊娠孕妇1141例,对照收集同期健康体检的育龄未孕妇女771例,测定其血浆Hcy、FA及Vit B_(12)水平,Hcy的检测采用化学发光法,FA和Vit B_(12)的检测采用时间分辨免疫荧光法。结果正常妊娠妇女Hcy、FA、Vit B_(12)水平均显著低于未孕对照组(P<0.05);不良妊娠妇女Hcy水平显著高于正常妊娠组(P<0.001);而不良妊娠组FA、Vit B_(12)水平均显著低于正常妊娠组(P<0.05);多元Logistic回归分析发现Hcy、年龄的升高以及Vit B_(12)水平的降低均对不良妊娠有重要的影响。结论 Hcy升高、年龄增大、Vit B_(12)缺乏均为不良妊娠发生的危险因素;Hcy、FA与Vit B_(12)的测定可以作为围孕期保健、预防不良妊娠的检测指标。
Objective To investigate the relationship between plasma homocysteine (Hcy), folic acid (FA) and vitamin B12 (Vit B_ (12)) and adverse pregnancy in women. Methods 601 pregnant women with adverse pregnancy outcomes and 1141 normal pregnant women were collected, and 771 pregnant women of childbearing age were collected during the same period. The levels of plasma Hcy, FA and Vit B 12 were measured. Hcy was detected by chemiluminescence, FA and Vit B_ (12) were detected by time-resolved immunofluorescence. Results The levels of Hcy, FA and Vit B_ (12) in normal pregnant women were significantly lower than those in non pregnant pregnant women (P <0.05). The levels of Hcy in adverse pregnant women were significantly higher than those in normal pregnant women (P <0.001) (P <0.05). The multivariate logistic regression analysis showed that Hcy, age and the decrease of Vit B 12 levels all had an important effect on adverse pregnancy. Conclusions Hcy, age and Vit B_ (12) deficiency are risk factors of adverse pregnancy. The determination of Hcy, FA and Vit B_ (12) can be used as a measure for the prevention and treatment of adverse pregnancy during pregnancy.