摘要
目的探讨亚甲基四氢叶酸还原酶(MTHFR)基因多态性对先兆流产孕妇血栓前状态的形成及妊娠结局的影响。方法选取2018年1月-2019年7月浙江省温州市中医院收治的先兆流产患者511例,根据妊娠结局分为顺利分娩组404例和不良妊娠组107例。对所有孕妇行MTHFR基因C677T位点的多态性检测,并检测孕妇血浆D-二聚体(D-D)、凝血酶时间(TT)、纤维蛋白原(Fbg)、血清同型半胱氨酸(Hcy),比较孕妇MTHFR基因型及凝血相关指标。结果不良妊娠组血清Hcy、血浆D-D水平较顺利分娩组高,差异有统计学意义(P<0.05)。不良妊娠组MTHFR C667T突变TT基因型所占比例较顺利分娩组高,差异有统计学意义(P<0.05),其他基因型两组比较差异无统计学意义(P>0.05)。结论先兆流产孕妇MTHFR C677T突变TT基因型更易形成血栓前状态及导致不良妊娠结局,可监测血清Hcy、血浆D-D水平并适时补充叶酸和维生素B12,改善高风险孕妇机体内环境,降低遗传因素对孕妇造成的不良影响。
Objective To investigate the influence of methylenetetrahydrofolate reductase(MTHFR)gene polymorphism on the formation of prethrombotic state and pregnancy outcome in pregnant women with threatened abortion.Methods A total of 511 patients with threatened abortion admitted to Wenzhou Hospital of Traditional Chinese Medicine in Zhejiang Province from January 2018 to July 2019 were selected.According to the pregnancy outcome,they were divided into 404 cases in the smooth delivery group and 107 cases in the poor pregnancy group.All pregnant women were tested for polymor-phism at the C677T locus of MTHFR gene,and the plasma D-dimer,TT,Fbg,and serum Hcy of pregnant women were detected,and the MTHFR genotype and blood coagulation related indexes of pregnant women were compared.Results The levels of serum Hcy and plasma D-dimer in the poor pregnancy group were higher than those in the smooth delivery group,and the difference was statistically significant(P<0.05).The proportion of mutant TT genotypes in the poor pregnancy group was higher than that in the smooth delivery group,and the difference was statistically significant(P<0.05).The other genotypes between the two groups were not statistically significant(P>0.05).Conclusion The MTHFRC677T mutant TT genotype of pregnant women with threatened abortion is more likely to form a prethrombotic state and lead to adverse pregnancy out-comes.Serum Hcy and plasma D-dimer levels can be monitored and folic acid and vitamin B12 can be supplemented in a timely manner to improve the internal environment of high-risk pregnant women and reduce the adverse effects of heredity factors on pregnant women.
作者
陈跃
孔万仲
CHEN Yue;KONG Wanzhong(Wenzhou Hospital of traditional Chinese Medicine,Wenzhou 325000,China)
出处
《浙江实用医学》
2021年第3期209-212,共4页
Zhejiang Practical Medicine
基金
温州市基础性科研项目(Y20190465)
