本文選題：心臟病 + 硒　； 參考：《中華疾病控制雜志》2017年10期

【摘要】：目的探討孕母全血中硒(selenium,Se)濃度與子代先天性心臟病(congenital heart disease,CHD)發(fā)生的關(guān)系。方法本病例對(duì)照研究選取懷有CHD胎兒的孕母為病例組(n=120),懷有心臟結(jié)構(gòu)正常胎兒的孕母作為對(duì)照組(n=108),并抽取外周靜脈血對(duì)孕母全血中Se元素進(jìn)行檢測(cè)。以Ln Se濃度三分位將全血中Se濃度分為低、中、高水平。運(yùn)用單因素和多因素Logistic回歸分析孕母全血中Ln Se含量與子代CHD發(fā)生的關(guān)系。結(jié)果病例組中孕母高中以下學(xué)歷、具有不良妊娠史以及吸煙比例高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(均有P0.05);單因素Logistic分析顯示,中濃度和高濃度的Se相對(duì)于低濃度Se,對(duì)CHD及間隔缺損、圓錐干畸形和右室流出道畸形亞型有保護(hù)作用。校正孕母年齡、孕前體質(zhì)指數(shù)(body mass index,BMI)、是否吸煙、樣本收集孕周以及是否服用葉酸等因素后,回歸分析結(jié)果顯示,相對(duì)于低濃度Se組,高濃度Se組發(fā)生CHD以及間隔缺損、圓錐干畸形和右室流出道畸形亞型的矯正的優(yōu)勢(shì)比(adjusted OR,a OR)分別為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),而且高濃度Se的保護(hù)作用強(qiáng)于中濃度Se。結(jié)論孕母血清Se水平升高與子代CHD的發(fā)生風(fēng)險(xiǎn)降低相關(guān)。
[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.
【作者單位】： 廣東省人民醫(yī)院(廣東省醫(yī)學(xué)科學(xué)院)產(chǎn)科;廣東省心血管病研究所廣東省人民醫(yī)院(廣東省醫(yī)學(xué)科學(xué)院)廣東省華南結(jié)構(gòu)性心臟病重點(diǎn)實(shí)驗(yàn)室心血管病流行病學(xué)研究室;
【基金】：廣東省科技計(jì)劃項(xiàng)目(2014A050503048)
【分類號(hào)】：R714

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