【摘要】 目的比较胎儿先天性心脏病（CHD）的孕妇和正常孕妇血清叶酸（Fol）、维生素B₁₂(VB₁₂)和同型半胱氨酸（Hcy）水平,以了解3种物质的代谢水平与胎儿CHD的关系。方法根据有无胎儿CHD将研究对象分为病例组（n=46）和对照组（n=43）。病例组为经B超诊断为孕CHD胎儿确诊的孕妇,对照组为经B超诊断胎儿发育正常的孕妇。检测89例研究对象血清标本Fol、VB₁₂和Hcy水平,比较病例组和对照组血清Fol、VB₁₂和Hcy水平差异。结果病例组的Fol水平高于对照组,差异有统计学意义（t=2.426,P=0.017）;病例组Hcy水平高低于对照组,但差异无统计学意义（P>0.05）。血清Fol≥44.5nmol/L的孕妇与<38.6nmoL/L的孕妇相比,胎儿CHD发生率降低36倍;Hcy的OR=1.036（95%CI:0.807¹.329）,但并未增加胎儿CHD发生的危险性（P>0.05）;VB₁₂的OR=1.007（95%CI:1.001¹.013）,增加胎儿CHD发生的危险性（P=0.015）。Fol和VB₁₂对CHD的发生都有关联,差异均有统计学意义（P=0.046,P=0.020）,但是曲线下的面积都<70%,用这两个指标单独进行诊断无很大价值。结论孕妇高水平Fol是妊娠胎儿CHD的保护因素,VB₁₂是妊娠胎儿CHD的危险因素,血清Fol和VB₁₂联合检测对胎儿CHD的发生更有预测价值。更多还原

【Abstract】 Objective To compare the levels of folate（Fol）,vitamin B₁₂(VB₁₂) and homocysteine（Hcy） between pregnant women with congenital heart disease（CHD） fetus and those with healthy fetus,and to investigate the relation between fetus CHD and the above three levels.Methods All cases were divided into case group（n =46） and control group（n =43） according to whether they had CHD fetus.By diagnosing with ultrasound scans,the pregnant women with CHD fetus were in the case group,and the pregnant women with healthy fetus were in the control group.The levels of Fol,VB₁₂ and Hcy in 89 samples were detected and compared between two groups.Results The level of Fol in the case group was higher than in the control group,and the difference was significant（t =2.426,P =0.017）.The level of Hcy in the case group was lower than the control group,but there was no statistical difference（P > 0.05）.Compared with the pregnant women with Fol≥44.5nmol/L,the incidence of fetus CHD among those with Fol <38.6nmol/L reduced 36 times.Hcy with OR value of1.036（95%CI:0.807-1.329） didnt increase the risk of fetus CHD（P>0.05）,but VB₁₂ with OR value of 1.007（95%CI:1.001-1.013） did（P =0.015）.Both Fol and VB₁₂ were related with the incidence of fetus CHD,and the difference was significant（P = 0.046,P= 0.020）.However,ROV area of them was less than 70%,so it was not valuable to diagnose fetus CHD by detecting Fol or VB₁₂.Conclusion High level of Fol is a protective factor and VB₁₂ is a dangerous factor for fetus CHD.It is valuable by combined detecting of Fol and VB₁₂ in diagnosing fetus CHD.更多还原