摘要
目的探讨妊娠晚期血清维生素A(VA)水平与网织红细胞参数及其新生儿脐带血VA水平的相关性。方法选取2018年3月至2018年12月东莞市黄江医院分娩的599例产妇及其新生儿作为研究对象,采用全自动血液分析仪检测其网织红细胞参数,采用高效液相色谱仪检测孕母及新生儿VA。分析母亲VA水平与网织红细胞参数的关系及其与新生儿VA水平的相关性。结果妊娠晚期VA水平与未成熟网织红细胞指数(IRF)呈负相关(r=-0.17,P<0.05),与网织红细胞血红蛋白含量(RET-He)及新生儿脐带血VA水平呈正相关(r=0.14,P<0.05;r=0.20,P<0.05),与网织红细胞绝对数(RET#)、网织红细胞百分比(RET%)无相关性(均P>0.05);VA缺乏组产妇的低荧光强度网织红细胞(LFR)(86.90±5.13%)和新生儿VA浓度(0.19±0.04mg/L)均低于正常组(88.46±5.06%,0.21±0.06mg/L)(t=3.18,P<0.05;t=4.73,P<0.05),而VA缺乏组产妇的中荧光强度网织红细胞(MFR)和IRF(11.94±4.40%,13.10±5.13%)均高于正常组(10.53±4.47%,11.54±5.06%),差异均有统计学意义(t=3.31,P<0.05;t=3.18,P<0.05)。产妇VA水平预测新生儿VA缺乏的ROC曲线下面积为0.63(95%CI:0.54~0.72),截断值为0.36mg/L,此时灵敏度为48.30%,特异度为75.00%。结论本地区产妇及新生儿VA缺乏情况较为严重,产妇VA缺乏可导致部分网织红细胞参数改变,并增加新生儿VA缺乏的发生率。因此孕妇需合理补充并维持VA在正常水平的高值,以减少妊娠期贫血和新生儿VA缺乏的发生率。
Objective To study correlation between serum vitamin A(VA)level of pregnant women in the third trimester and their reticulocyte parameters,and correlation between maternal serum VA level and neonatal VA level in umbilical cord blood.Methods 599parturients and their newborns who delivered and gave a birth in our hospital from March 2018to December 2018were selected as study subjects.Reticulocyte parameters were detected by automatic blood analyzer,and maternal VA level and their babies'VA level in umbilical cord blood were detected by high performance liquid chromatography/tandem mass spectrometer(LC/MS).According to maternal serum level of VA,the pregnant women were divided into two groups:VA deficiency group and VA normal group.The reticulocyte parameters of the pregnant women between the two groups and maternal serum level of VA and their infants'VA level were compared respectively.The correlations between maternal VA serum level in late pregnancy and their reticulocyte parameters and between maternal VA serum level in late pregnancy and their infant's level of VA in the cord blood were analyzed.Results Maternal serum level of VA was negatively correlated with their immature reticulocyte fraction(IRF)(r=-0.17,P<0.05),and positively correlated with maternal reticulocyte hemoglobin content(RET-He)(r=0.14,P<0.05)and infants'VA level in umbilical cord blood(r=0.20,P<0.05),but it was not correlated with their reticulocyte count(RET#)and percentage of reticulocytes(RET%)(both P>0.05).Maternal low fluorescence intensity reticulocytes(LFR)(86.90±5.13%)and neonatal VA level(0.19±0.04mg/L)in VA deficiency group were both lower than those in VA normal group(88.46±5.06%,0.21±0.06mg/L)(t=3.18and 4.73respectively,both P<0.05),while medium fluorescence intensity reticulocytes(MFR)(11.94±4.40%)and IRF(13.10±5.13%)were higher than those in VA normal group(10.53±4.47%and 11.54±5.06%respectively),there were statistically significant differences(t=3.31and 3.18respectively,both P<0.05).The area under ROC of infant's VA deficiency predicted by maternal serum level of VA was 0.63(95%CI:0.54~0.72),the cut-off value was 0.36mg/L,where the sensitivity was 48.30%and the specificity was 75.00%.Conclusion VA deficiencies both in the pregnant women in late pregnancy and their infants are serious in this region.VA deficiency in late pregnancy can lead to changes in some of their reticulocyte parameters and increase incidence of their infant's VA deficiency.Pregnant women need to supplement VA reasonably and maintain their serum level of VA at a high value of normal range to reduce incidence of anemia so as to improve their infants VA level and ensure health of the mother and the infant.
作者
周茜
叶姗羽
庞敏宜
罗广华
钟梅
ZHOU Qian;YE Shanyu;PANG Minyi;LUO Guanghua;ZHONG Mei(Huangjiang Hospital of Dongguan City,Guangdong Dongguan 523750,China;Nanfang Hospital Affiliated to Southern Medical University,Guangdong Guangzhou 510515,Chin)
出处
《中国妇幼健康研究》
2020年第3期343-346,共4页
Chinese Journal of Woman and Child Health Research
基金
国家卫计委医药卫生科技发展研究中心科研项目(编号:W2016CWGD01)。
关键词
维生素A
网织红细胞
妊娠晚期
脐带血
vitamin A(VA)
reticulocyte
late pregnancy
umbilical cord blood
