孕婦血清中維生素A、E水平調查和分析
發(fā)布時間：2018-07-18 21:52
【摘要】：目的調查孕婦早(11-13+6周)、中(24-25+6周)、晚(≥31周)期血清中維生素A、E水平,分析其相關影響因素,以及其與妊娠結局的關系,為孕婦進行合理營養(yǎng)指導提供依據(jù)。方法隨機選取2015年10月至2016年3月在天津市中心婦產科醫(yī)院產科門診進行產前檢查及孕晚期住院分娩的符合納入標準的單胎孕婦2740例,采用高效液相色譜法定量測定血清維生素A、E的濃度,同時通過問答形式的問卷調查收集孕婦飲食及藥物補充情況,并記錄孕婦一般資料和最終妊娠結局。以妊娠結局為因變量(患某種病=1,未患某種病=0),孕婦外周血中維生素A、E水平、孕婦妊娠時年齡為自變量,采用非條件二項分類Logistic回歸分析孕婦血清中維生素A、E水平與妊娠結局的關系。結果1.妊娠早、中、晚期孕婦血清中維生素A濃度分別為(0.47±0.095)mg/L、(0.48±0.323)mg/L、(0.39±0.111)mg/L,三期總異常率11.71%,以缺乏為主(88.81%)。晚期維生素A濃度最低(P0.05),異常率最高(19.65%),其中重度缺乏率(0.2mg/L)6.72%。2.妊娠早、中、晚期孕婦血清中維生素E濃度分別為(11.33±2.521)mg/L、(15.78±3.493)mg/L、(17.99±4.571)mg/L,三期總異常率16.21%,以過量為主(99.75%)。隨孕周增加維生素E濃度和異常率均增加,妊娠晚期濃度最高,異常率最高(26.83%)(P0.05),為維生素E過量。3.維生素E濃度與年齡和孕產次呈正相關,但孕晚期與孕產次呈負相關且當孕婦年齡≥40時呈下降趨勢。維生素A濃度與孕產次無明顯相關,在孕早、中期與年齡呈正相關,孕晚期與年齡無相關。4在日常膳食基礎上,孕早期堅果類食物攝入增加則維生素A、E濃度升高,孕晚期維生素A、E濃度隨每日肉類攝入量和動物內臟的攝入頻次增加而增加。5.在基礎膳食情況近似的條件下,孕早期開始補充含維生素A、E的同種復合維生素其血清中維生素A、E濃度高于僅在孕中晚期補充者。6.孕早期和孕晚期血清中維生素A、E濃度對妊娠期高血壓相關疾病(除外慢性高血壓合并妊娠和子癇分型)、PROM和PPROM的發(fā)生無明顯影響。7.孕婦血清中維生素A、E濃度與GDM的發(fā)生相關(P0.05),維生素A、E濃度在正常范圍值時(維生素A濃度為0.3-0.7mg/L,維生素E濃度5-20mg/L)是GDM的保護因素,且孕早期開始補充復合維生素可明顯降低GDM的發(fā)生率。8.GDM組維生素E過量率顯著高于非GDM組。9.本研究人群中妊娠年齡越大GDM的發(fā)生風險越高。結論1.調查人群中維生素A異常以缺乏為主,建議孕期常規(guī)足量補充維生素A;維生素E異常以過量為主,占99.75%,應監(jiān)測后合理補充。在日常膳食基礎上,孕早期開始補充復合維生素可有效改善維生素A、E缺乏。2.孕期維生素A、E濃度受孕婦年齡、孕產次以及飲食多因素共同影響,孕期應定期監(jiān)測,進行營養(yǎng)指導時根據(jù)孕婦自身需要制定個體化補充方案,避免維生素E過量。3.建議GDM高危孕婦應從孕早期開始口服含維生素A、E的復合維生素預防GDM的發(fā)生改善不良妊娠結局。4.由于維生素A、E無論缺乏還是過量GDM的發(fā)生風險均增加,因此在補充維生素A、E的同時應定期監(jiān)測其濃度,避免因維生素A、E濃度異常導致不良妊娠結局。
[Abstract]:Objective to investigate the serum vitamin A and E levels in the serum of pregnant women (11-13+6 weeks), middle (24-25+6 weeks) and late (more than 31 weeks), and to analyze the related factors, as well as their relationship with pregnancy outcome, and provide basis for rational nutrition guidance for pregnant women. Methods randomly selected from October 2015 to March 2016 were carried out in the obstetric clinic in Tianjin Central Obstetrics and Gynecology Hospital. Prenatal examination and inpatient delivery in the late pregnancy were 2740 cases of single pregnant women who were included in the standard. The serum vitamin A, E concentration was measured by high performance liquid chromatography (HPLC), and the dietary and drug supplementation of pregnant women were collected through a question and answer questionnaire and the pregnant women's general information and final pregnancy outcome were recorded. The amount of vitamin A and E in pregnant women's peripheral blood and the age of pregnant women in pregnancy were independent variables. The relationship between vitamin A, E level and pregnancy outcome in pregnant women's serum was analyzed by unconditional two classification Logistic regression. Results the serum vitamin A concentration in pregnant women was (0.47 + 0.095) mg/L respectively (0.47 + 0.095) mg/L, respectively. (0.48 + 0.323) mg/L, (0.39 + 0.111) mg/L, three total abnormal rate 11.71%, with the lack of main (88.81%). The lowest (P0.05) in advanced vitamin A (P0.05), the highest rate (19.65%), of which severe deficiency (0.2mg/L) 6.72%.2. pregnancy early, in the late pregnant women, the concentration of vitamin E in the blood of the late pregnant women is (11.33 + 2.521) mg/L, (15.78 + 3.493) mg/L, (17.99 + 4.571) mg/. L, the total abnormal rate of the three stage was 16.21%, which was overdose (99.75%). The concentration and abnormal rate of vitamin E increased with the gestational age, the highest in the late pregnancy, the highest (26.83%) (P0.05). The concentration of vitamin E overdose.3. vitamin E was positively correlated with age and pregnancy, but the late pregnancy was negatively correlated with pregnancy and when the age of pregnant women was more than 40 There was no significant correlation between the concentration of vitamin A and pregnancy. It was positively correlated with age in the early pregnancy and the middle period. The late pregnancy and age did not relate to.4 on the basis of daily diet, the increase of vitamin A, E concentration in the early pregnancy and the increase of vitamin A, E concentration in the late pregnancy increased with the daily intake of meat and the intake frequency of animal viscera. Adding and increasing.5. in the condition of the basic diet, the early pregnancy began to supplement vitamin A, E, and vitamin A in the serum, E concentration was higher than the serum vitamin A in the early and late trimester of pregnancy and in the late trimester of pregnancy, and the concentration of E for high blood pressure related diseases of pregnancy (except for chronic hypertension combined with pregnancy and pregnancy). The occurrence of PROM and PPROM had no significant effect on vitamin A in serum of.7. pregnant women, and the concentration of E was associated with the occurrence of GDM (P0.05). The concentration of vitamin A and E at the normal range (vitamin A concentration was 0.3-0.7mg/L, vitamin E concentration) was a protective factor. The rate of vitamin E overdose in the group.8.GDM was significantly higher than that in the non GDM group, and the higher the risk of GDM was higher in the group of.9.. Conclusion the abnormal vitamin A in the 1. population was mainly deficient in vitamin A, and the vitamin A supplementation was recommended during pregnancy; the abnormal vitamin E was mainly excessive, accounting for 99.75%. In the early pregnancy, supplementation of vitamin A in the early pregnancy can effectively improve vitamin A, E lack of vitamin A during pregnancy, E concentration is affected by pregnant women's age, pregnant times and dietary factors. The pregnancy should be monitored regularly during pregnancy. In the course of nutrition guidance, a individualized supplemental scheme is made according to the needs of pregnant women to avoid vitamin E excessive.3. to suggest GDM risk. Pregnant women should begin to take oral vitamin A, E complex vitamins to prevent GDM from the early pregnancy to improve the adverse pregnancy outcome,.4. due to vitamin A, E no matter or excessive GDM risk increased, therefore, vitamin A, E should be regularly monitored at the same time, avoid due to vitamin A, E concentration abnormal lead to adverse pregnancy outcomes.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714
本文編號：2132887
[Abstract]:Objective to investigate the serum vitamin A and E levels in the serum of pregnant women (11-13+6 weeks), middle (24-25+6 weeks) and late (more than 31 weeks), and to analyze the related factors, as well as their relationship with pregnancy outcome, and provide basis for rational nutrition guidance for pregnant women. Methods randomly selected from October 2015 to March 2016 were carried out in the obstetric clinic in Tianjin Central Obstetrics and Gynecology Hospital. Prenatal examination and inpatient delivery in the late pregnancy were 2740 cases of single pregnant women who were included in the standard. The serum vitamin A, E concentration was measured by high performance liquid chromatography (HPLC), and the dietary and drug supplementation of pregnant women were collected through a question and answer questionnaire and the pregnant women's general information and final pregnancy outcome were recorded. The amount of vitamin A and E in pregnant women's peripheral blood and the age of pregnant women in pregnancy were independent variables. The relationship between vitamin A, E level and pregnancy outcome in pregnant women's serum was analyzed by unconditional two classification Logistic regression. Results the serum vitamin A concentration in pregnant women was (0.47 + 0.095) mg/L respectively (0.47 + 0.095) mg/L, respectively. (0.48 + 0.323) mg/L, (0.39 + 0.111) mg/L, three total abnormal rate 11.71%, with the lack of main (88.81%). The lowest (P0.05) in advanced vitamin A (P0.05), the highest rate (19.65%), of which severe deficiency (0.2mg/L) 6.72%.2. pregnancy early, in the late pregnant women, the concentration of vitamin E in the blood of the late pregnant women is (11.33 + 2.521) mg/L, (15.78 + 3.493) mg/L, (17.99 + 4.571) mg/. L, the total abnormal rate of the three stage was 16.21%, which was overdose (99.75%). The concentration and abnormal rate of vitamin E increased with the gestational age, the highest in the late pregnancy, the highest (26.83%) (P0.05). The concentration of vitamin E overdose.3. vitamin E was positively correlated with age and pregnancy, but the late pregnancy was negatively correlated with pregnancy and when the age of pregnant women was more than 40 There was no significant correlation between the concentration of vitamin A and pregnancy. It was positively correlated with age in the early pregnancy and the middle period. The late pregnancy and age did not relate to.4 on the basis of daily diet, the increase of vitamin A, E concentration in the early pregnancy and the increase of vitamin A, E concentration in the late pregnancy increased with the daily intake of meat and the intake frequency of animal viscera. Adding and increasing.5. in the condition of the basic diet, the early pregnancy began to supplement vitamin A, E, and vitamin A in the serum, E concentration was higher than the serum vitamin A in the early and late trimester of pregnancy and in the late trimester of pregnancy, and the concentration of E for high blood pressure related diseases of pregnancy (except for chronic hypertension combined with pregnancy and pregnancy). The occurrence of PROM and PPROM had no significant effect on vitamin A in serum of.7. pregnant women, and the concentration of E was associated with the occurrence of GDM (P0.05). The concentration of vitamin A and E at the normal range (vitamin A concentration was 0.3-0.7mg/L, vitamin E concentration) was a protective factor. The rate of vitamin E overdose in the group.8.GDM was significantly higher than that in the non GDM group, and the higher the risk of GDM was higher in the group of.9.. Conclusion the abnormal vitamin A in the 1. population was mainly deficient in vitamin A, and the vitamin A supplementation was recommended during pregnancy; the abnormal vitamin E was mainly excessive, accounting for 99.75%. In the early pregnancy, supplementation of vitamin A in the early pregnancy can effectively improve vitamin A, E lack of vitamin A during pregnancy, E concentration is affected by pregnant women's age, pregnant times and dietary factors. The pregnancy should be monitored regularly during pregnancy. In the course of nutrition guidance, a individualized supplemental scheme is made according to the needs of pregnant women to avoid vitamin E excessive.3. to suggest GDM risk. Pregnant women should begin to take oral vitamin A, E complex vitamins to prevent GDM from the early pregnancy to improve the adverse pregnancy outcome,.4. due to vitamin A, E no matter or excessive GDM risk increased, therefore, vitamin A, E should be regularly monitored at the same time, avoid due to vitamin A, E concentration abnormal lead to adverse pregnancy outcomes.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R714
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