CAJ | 학술논문

目的探讨围孕期妇女营养摄入与胎儿先天性心脏病(CHD)发生的关系. 方法采用以医院为基础的病例-对照研究设计, 按照纳入和剔除标准选择100例CHD胎儿孕母为病例组,100例健康胎儿孕母作为对照组,调查孕母围孕期营养摄入情况,同时采集调查对象外周静脉血,检测MTHFRC677T 基因多态性,血清同型半胱氨酸(Hcy)、叶酸及维生素B12(VitB12)水平. 采用单因素和多因素非条件Logistic回归模型,进行胎儿CHD影响因素的分析. 结果非条件Logistic回归分析显示,孕母围孕期奶类摄入<5次/周是影响胎儿CHD发生的危险因素 (OR=3.250,95%CI:1.785~5.916). 孕母MTHFR677TT基因型与围孕期营养摄入<5次/周之间在CHD发病中均为负相加模型交互作用,且不同MTHFRC677T基因型对其血清Hcy未产生明显影响 (F=0.629、1.872,P>0.05). 血清 Hcy 水平病例组明显高于对照组, 且差异有统计学意义 (t=-8.141,P<0.01),血清叶酸和VitB12水平与血清Hcy水平呈负相关(r=-0.281和-0.236,P均<0.01). 结论血清高Hcy水平是子代CHD的危险因素, 未发现孕母MTHFRC677T基因多态性与子代CHD发病存在关联,经常补充富含叶酸和B族维生素的食物或可降低子代CHD的发病风险.
목적 탐토위잉기부녀영양섭입여태인선천성심장병(CHD)발생적관계. 방법 채용이의원위기출적병례-대조연구설계, 안조납입화척제표준선택100례CHD태인잉모위병례조,100례건강태인잉모작위대조조,조사잉모위잉기영양섭입정황,동시채집조사대상외주정맥혈,검측MTHFRC677T 기인다태성,혈청동형반광안산(Hcy)、협산급유생소B12(VitB12)수평. 채용단인소화다인소비조건Logistic회귀모형,진행태인CHD영향인소적분석. 결과 비조건Logistic회귀분석현시,잉모위잉기내류섭입<5차/주시영향태인CHD발생적위험인소 (OR=3.250,95%CI:1.785~5.916). 잉모MTHFR677TT기인형여위잉기영양섭입<5차/주지간재CHD발병중균위부상가모형교호작용,차불동MTHFRC677T기인형대기혈청Hcy미산생명현영향 (F=0.629、1.872,P>0.05). 혈청 Hcy 수평병례조명현고우대조조, 차차이유통계학의의 (t=-8.141,P<0.01),혈청협산화VitB12수평여혈청Hcy수평정부상관(r=-0.281화-0.236,P균<0.01). 결론 혈청고Hcy수평시자대CHD적위험인소, 미발현잉모MTHFRC677T기인다태성여자대CHD발병존재관련,경상보충부함협산화B족유생소적식물혹가강저자대CHD적발병풍험.
Objective To explore the relationship between the nutrition intake of pregnant women before and during pregnancy and their fetal congenital heart disease (CHD). Methods A case-control study was conducted bases on hospital , in which 100 pregnant women were selected as case group and 100 as control group according to the study criterions. The nutrition intake before and during pregnancy were investigated , and the venous blood samples were gathered. The genotype of MTHFRC677T , serum homocysteine (Hcy), folic acid , vitamin B12 were detected. Single factor and multi-factor non conditional logistic regression model were used to analyze the influence factors of fetal CHD. Results Non-conditional logistic regression analysis showed that milk intake < 5 times/week of pregnant women was the risk factor for fetal CHD (OR=3.250, 95%CI: 1.785-5.916). The interaction analysis showed that nutrition intake < 5 times/week combined with MTHFR677TT genotype could have negative adding effect on the occurring of CHD , and different MTHFRC677T genotypes had no obvious effect on serum Hcy (F=0.629 and 1.872, P>0.05). Serum Hcy levels in case group was significantly higher than that in control group (t=-8.141,P<0.01). Serum folate and vitamin B12 levels were negatively correlated with serum Hcy levels (r=-0.281 and -0.236, P<0.01). Conclusions High level of serum Hcy is the risk factor of fetal CHD. MTHFRC677T polymorphism of pregnant women has no connection with fetal CHD. Taking supplement food which are rich in folic acid and B vitamins may reduce the risk of fetal CHD.