基因检测科学补充叶酸对妇女妊娠的影响

发布时间：2018-11-04 12:47

【摘要】：根据孕妇叶酸代谢障碍情况指导病人个体化服用叶酸,追踪随访孕妇妊娠并发症及结局。比较不同人群出现不良妊娠结局的机率,强调孕期应用基因检测方法个体化服用叶酸的重要性,达到优生优育。目的调查通过基因检测技术指导病人个体化服用叶酸对妇女妊娠的影响材料与方法1研究对象选取2013年9月至2014年12月来郑大三附院行叶酸风险评估检查并按照基因检测结果科学补充叶酸的孕妇591例(研究组),未按基因检测结果科学补充叶酸的孕妇700例(对照组),相关信息采用统一调查问卷。追踪其妊娠并发症及结局。2研究方法取病人两侧口腔黏膜细胞,应用国际上通用的荧光定量PCR检测技术,检测影响叶酸代谢的三组基因MTHFR C677T,A1298C和MTRR A66G的多态性分布,根据基因多态性分布将孕产妇叶酸代谢障碍分成未发现风险、低度风险、中度风险、高度风险四个风险级别。指导孕产妇个体化服用叶酸,追踪其妊娠结局,对比分析研究组和对照组妊娠结局。3统计学处理用SPSS17.0软件对所取得的数据行统计学处理和分析,计数资料用百分比表示,组间差异比较采用χ2检验;计量资料用均数±标准差(χ±s)表示,组间差异比较用独立样本t检验,均以α=0.05为检验水准。结果1.研究组(29.910±4.682岁,162.55±3.905cm,60.060±6.694Kg)和对照组(30.190±5.491岁,161.80±4.189 cm,58.520±7.207 Kg)研究对象在年龄、身高、体质量方面的差异无统计学意义。2.研究组和对照组在自然流产组(χ2=9.386,P值0.0020.05)比较有统计学意义;在胎儿先天发育畸形(唇腭裂,先心病,畸形引产)组比较有统计学意义;在胎儿宫内生长受限组(χ2=4.254,P值0.0390.05)比较有意义;在早产组(χ2=7.381,P值0.0070.05)比较有统计学意义;在巨大儿组(χ2=5.116,P值0.0240.05)比较有统计学意义;在葡萄胎组比较(χ2=0.024,P值0.8760.05)比较无统计学意义。3.研究组和对照组在妊娠高血压组(χ2=19.185,P值0.0000.05)比较有统计学意义;在妊娠期贫血组(χ2=36.087,P值0.0000.05)比较有统计学意义;在妊娠期糖尿病组(χ2=1.185,P值0.2760.05)比较无统计学意义。结论1.基因检测科学补充叶酸与自然流产、胎儿先天发育畸形、早产、胎儿生长受限、胎儿先心病的发生有相关性;2.基因检测科学补充叶酸与新生儿健康状况有相关性。3.基因检测科学补充叶酸与妊娠期高血压、贫血的发生有相关性。
[Abstract]:According to the disorder of folic acid metabolism in pregnant women, the patients were given folic acid individualized, and the complications and outcomes of pregnancy were followed up. To compare the probability of adverse pregnancy outcome in different population, the importance of individualized folic acid use in pregnancy was emphasized. Objective to investigate the influence materials and methods of individualized folic acid administration on pregnancy in women by gene detection technique. The subjects were selected from September 2013 to December 2014 to perform folic acid risk assessment in the third affiliated Hospital of Zhengzhou University. 591 pregnant women with folic acid supplementation (study group), 700 pregnant women who did not supplement folic acid scientifically according to the results of gene test (control group) were investigated with unified questionnaire. Methods the oral mucosal cells of both sides of the patients were collected to detect the polymorphisms of three groups of genes MTHFR C677TnA1298C and MTRR A66G, which affect folate metabolism by fluorescence quantitative PCR assay. According to the distribution of gene polymorphism, maternal folate metabolic disorders were divided into four risk levels: undetected risk, low risk, moderate risk and high risk. The pregnant women were instructed to take folic acid individually, to track their pregnancy outcomes, and to compare and analyze the pregnancy outcomes of the study group and the control group. 3 the data obtained were statistically processed and analyzed with SPSS17.0 software, and the counting data were expressed in percentage. 蠂 2 test was used to compare the differences between groups. The measurement data were expressed as mean 卤standard deviation (蠂卤s). The difference between groups was compared by independent sample t test, and the test level was 伪 = 0.05. Result 1. There was no significant difference in age, height and body mass between the study group (29.910 卤4.682 years old, 162.55 卤3.905 cm-1 卤6.694Kg) and the control group (30.190 卤5.491 years old, 161.80 卤4.189 cm,58.520 卤7.207 Kg). There was significant difference between the study group and the control group in the spontaneous abortion group (蠂 2 9.386 P value 0.0020.05), the fetal congenital developmental malformation (cleft lip and palate, congenital heart disease, abnormal induced labor) group. There was significant difference in fetal growth restriction group (蠂 ~ 2 ~ 2 ~ (4.254) P value 0.0390.05) and premature delivery group (蠂 ~ (2 +) 7.381g ~ (-1) P value 0.007 ~ (0.05). There was statistical significance in macrosomia group (蠂 2 = 5.116 P = 0.0240.05), but in hydatidiform mole group (蠂 ~ 2 = 0.024 P = 0.8760.05). 3. There were significant differences between the study group and the control group in the pregnancy hypertension group (蠂 2 + 19.185 P = 0.0000.05), the pregnant anemia group (蠂 2 + 36.087g P = 0.0000.05) and the pregnant anemia group (P = 0.0000.05). There was no significant difference in gestational diabetes mellitus group (蠂 2 + 1.185 P = 0.2760.05). Conclusion 1. Gene detection was associated with natural abortion, congenital malformation of fetus, premature delivery, fetal growth restriction and fetal congenital heart disease. 2. Genetic detection of scientific supplementation of folic acid and neonatal health. 3. 3. Folic acid supplementation is associated with hypertension and anemia in pregnancy.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714

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