孕母全血中硒浓度与子代先天性心脏病发生的关系

发布时间：2018-05-01 02:06

本文选题：心脏病 + 硒　；参考：《中华疾病控制杂志》2017年10期

【摘要】：目的探讨孕母全血中硒(selenium,Se)浓度与子代先天性心脏病(congenital heart disease,CHD)发生的关系。方法本病例对照研究选取怀有CHD胎儿的孕母为病例组(n=120),怀有心脏结构正常胎儿的孕母作为对照组(n=108),并抽取外周静脉血对孕母全血中Se元素进行检测。以Ln Se浓度三分位将全血中Se浓度分为低、中、高水平。运用单因素和多因素Logistic回归分析孕母全血中Ln Se含量与子代CHD发生的关系。结果病例组中孕母高中以下学历、具有不良妊娠史以及吸烟比例高于对照组,差异有统计学意义(均有P0.05);单因素Logistic分析显示,中浓度和高浓度的Se相对于低浓度Se,对CHD及间隔缺损、圆锥干畸形和右室流出道畸形亚型有保护作用。校正孕母年龄、孕前体质指数(body mass index,BMI)、是否吸烟、样本收集孕周以及是否服用叶酸等因素后,回归分析结果显示,相对于低浓度Se组,高浓度Se组发生CHD以及间隔缺损、圆锥干畸形和右室流出道畸形亚型的矫正的优势比(adjusted OR,a OR)分别为0.29(95%CI:0.14~0.61)、0.37(95%CI:0.17~0.82)、0.22(95%CI:0.07~0.64)和0.11(95%CI:0.03~0.44),而且高浓度Se的保护作用强于中浓度Se。结论孕母血清Se水平升高与子代CHD的发生风险降低相关。
[Abstract]:Objective to investigate the relationship between the concentration of selenium seleniumus See in the whole blood of pregnant mothers and the occurrence of congenital heart disease (heart disease). Methods in this case-control study, pregnant women with CHD fetus were selected as case group, and pregnant mothers with normal heart structure were used as control group, and peripheral venous blood was taken to detect se in maternal whole blood. The whole blood se concentration was divided into low, medium and high levels by Ln se three position. Univariate and multivariate Logistic regression analysis was used to analyze the relationship between Ln se content in maternal blood and the occurrence of CHD in offspring. Results in the case group, the pregnant mother had less than high school education, had bad pregnancy history and smoking rate, the difference was statistically significant (P 0.05), the univariate Logistic analysis showed that, The medium and high concentrations of se have protective effect on CHD and septal defect, conical malformation and right ventricular outflow tract malformation compared with low concentration of se. After adjusting maternal age, body mass index (BMI) before pregnancy, smoking or smoking, collecting samples for gestational weeks and taking folic acid, regression analysis showed that CHD and septal defect occurred in high concentration se group compared with low concentration se group. The advantages of correction of the subtypes of trunk conical malformation and right ventricular outflow tract malformation were 0.29 ~ 95% CI: 0.14 0. 661% 0.3795% CI: 0.170.82% 0.2295 CI: 0.07% 0.64) and 0.1195% CIW 0.030.44 O) respectively, and the protective effect of high concentration se was stronger than that of medium concentration See. Conclusion the increase of serum se level in pregnant women is associated with lower risk of CHD in offspring.
【作者单位】：广东省人民医院(广东省医学科学院)产科;广东省心血管病研究所广东省人民医院(广东省医学科学院)广东省华南结构性心脏病重点实验室心血管病流行病学研究室;
【基金】：广东省科技计划项目(2014A050503048)
【分类号】：R714

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