免疫相关性复发性流产患者血清B族维生素水平的研究

来源:用户上传      作者:卢阳 陈萍 林素仙 王胜男 姜建昌 张智勇 杨美绿

　　[摘要] 目的 回顾性分析免疫相关性复发性流产患者水溶性B族维生素水平的数据，为临床干预提供参考依据。方法 选取2020年7月至2021年5月在浙江省温州市人民医院就诊的免疫相关性复发性流产患者为流产组（n=40），同期未孕妇女为对照组（n=31），采用高效液相色谱串联质谱分析测定流产组与对照组的外周血中维生素B1、B2、B3、B5、B6、B9水平。结果 流产组与对照组比较，两组的维生素B2、B3、B5、B6水平相比差异无统计学意义（P>0.05）。流产组的维生素B1水平为2.160（1.518，2.505）ng/ml，对照组维生素B1水平为2.710（2.050，3.390）ng/ml;两组的维生素B1水平对比，差异有统计学意义。流产组的维生素B9水平为8.535（6.473，10.850）ng/ml，对照组的维生素B9水平为9.850（8.230，12.650）ng/ml;两组的维生素B9水平对比，差异有统计学意义。结论 维生素B1、B9可能是免疫相关性复发性流产发生、发展的一个重要因素，维生素B1、B9的检测对免疫相关性复发性流产患者的预防及治疗具有一定的临床意义，补充维生素B1、B9是可能的治疗靶点之一。
　　[关键词] 复发性流产;水溶性B族维生素;维生素B1;维生素B9
　　[中图分类号] R714.21 [文献标识码] B [文章编号] 1673-9701（2022）13-0082-04
　　[Abstract] Objective To retrospectively analyze the data of water-soluble B group vitamins in patients with immune-related recurrent spontaneous abortion， so as to provide a reference for clinical interventions. Methods A total of 40 patients with immune-related recurrent spontaneous abortion of Wenzhou People′s Hospital in Zhejiang Province from July 2020 to May 2021 were selected as the abortion group and 31 contemporaneous non-pregnant women as the control group. The levels of vitamins B1， B2， B3， B5， B6 and B9 in peripheral blood of the abortion group and the control group were determined by high performance liquid chromatography tandem mass spectrometry. Results To compare the abortion group with the control group， there were no statistically significant differences in the levels of vitamins B2， B3， B5 and B6 between the two groups （P>0.05）. The level of vitamin B1 in the abortion group was 2.160 （1.518， 2.505） ng/ml， and that in the control group was 2.710 （2.050， 3.390） ng/ml. There was a significant difference in the vitamin B1 level between the two groups. The level of vitamin B9 in the abortion group was 8.535 （6.473， 10.850） ng/ml， and that in the control group was 9.850 （8.230， 12.650） ng/ml. There was a significant difference in the vitamin B9 level between the two groups. Conclusion Vitamins B1 and B9 may be important factors in the occurrence and development of immune-related recurrent spontaneous abortion. Its detection is of certain clinical significance for the prevention and treatment of immune-related recurrent spontaneous abortion. Vitamins B1 and B9 supplementation is one of the potential therapeutic targets.
　　[Key words] Recurrent spontaneous abortion; Water-soluble B group vitamins; Vitamin B1; Vitamin B9
　　头⑿粤鞑（recurrent spontaneous abortion，RSA）指同一女性与同一伴侣持续发生2次及其以上流产[1]，发生率约为1%，是育龄妇女的常见病。该病再次妊娠可能发生自然流产的风险高，对患者家庭幸福与身心健康影响极大。复发性流产原因复杂，包括染色体、解剖、内分泌、自身免疫异常和生殖道感染等常见病因[2]，其中免疫因素在复发性流产中起着重要作用，根据免疫性流产的发病机制不同，可分为自身免疫型和同种免疫型，自身免疫型主要包括自身免疫性疾病和自身免疫性抗体异常[3]。对免疫相关性复发性流产患者进行针对性与规范性的临床治疗，对患者预后有极大的重要意义。因此，本研究观察免疫相关性复发性流产患者与正常人群B族维生素水平的差异，旨在为下一步B族维生素对免疫相关性复发性流产患者的干预进行初探，现报道如下。

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