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目的:分析孕妇红细胞叶酸水平与胎儿先天性缺陷之间的关系。方法:选择2007年1月～2008年10月超声诊断为胎儿缺陷的病例93例(缺陷儿组),随机选择同期正常妊娠的孕妇184例(对照组),采用时间分辨荧光法检测孕妇外周血红细胞叶酸水平。结果:93例缺陷儿孕妇外周血红细胞叶酸水平为(799.74±333.30)nmol/L,对照组为(1 003.30±466.78)nmol/L,两者相比差异具有统计学意义。缺陷儿组中各亚组的红细胞叶酸水平分别为:开放性神经管畸形(NTDs)组(743.75±386.41)nmol/L,单纯脑室扩张组(847.46±448.52)nmol/L,先天性心脏病组(753.33±266.31)nmol/L,骨骼系统发育异常组(844.00±339.85)nmol/L,淋巴水囊瘤组(816.22±330.12)nmol/L,泌尿系统发育异常组(865.50±166.79)nmol/L,唇腭裂组(854.00±369.54)nmol/L。胎儿缺陷组各亚组中只有NTDs组和先天性心脏病组与对照组相比差异具有统计学意义。结论:胎儿缺陷与孕妇叶酸缺乏有关,其中开放性神经管畸形和先天性心脏病最为相关;孕期红细胞叶酸平均最佳水平应该在1000 nmol/L左右;孕前和孕早期补充足量的叶酸可以预防多种胎儿畸形的发生,尤其是NTDs和先天性心脏病。
Objective: To analyze the relationship between the level of folic acid in pregnant women and congenital defects of fetus. Methods: A total of 93 pregnant women with defective fetuses diagnosed by ultrasound from January 2007 to October 2008 were selected and 184 pregnant women (normal control group) were randomly selected. The peripheral blood of pregnant women was detected by time-resolved fluorescence Erythrocyte folate levels. Results: The levels of peripheral blood erythrocyte folic acid in 93 infants were (799.74 ± 333.30) nmol / L and those in the control group were (1003.30 ± 466.78) nmol / L, respectively. There was significant difference between the two groups. The levels of erythrocyte folic acid in the subgroups in the defect group were: NTDs (743.75 ± 386.41) nmol / L, simple ventricular expansion (847.46 ± 448.52) nmol / L, congenital heart disease (753.33 ± 266.31) nmol / L, skeletal dysplasia group (844.00 ± 339.85) nmol / L, lymphocystoma group (816.22 ± 330.12) nmol / L and urinary system dysplasia group (865.50 ± 166.79) nmol / L , Cleft lip and palate group (854.00 ± 369.54) nmol / L. There was significant difference between NTDs group and congenital heart disease group in the fetal defect group and the control group. Conclusions: Fetal defects are related to folic acid deficiency in pregnant women. Among them, open neural tube defects are most closely related to congenital heart disease. The best average level of folic acid during pregnancy should be about 1000 nmol / L. Adequate folic acid can be prevented before and during pregnancy A variety of fetal malformations, especially NTDs and congenital heart disease.