与子代先心病相关的孕前女性同型半胱氨酸风险值研究-东南大学学报医学版

与子代先心病相关的孕前女性同型半胱氨酸风险值研究

作者：石慧¹ 杨世伟² 孙晓如¹ 姜志欣¹ 王丽娟¹ 程学英² 黄丽丽¹ 陈伟¹ 王参军³ 吴玉璘¹ 许豪勤¹ 林宁¹

单位：1. 江苏省生殖健康检验中心/江苏省计划生育科学技术研究所实验筛检中心, 江苏南京 210036;
2. 南京市儿童医院心内科, 江苏南京 210008;
3. 东南大学附属中大医院检验科, 江苏南京 210009

分类号：R715.3

出版年·卷·期（页码）：2018·37·第四期（593-596）

摘要：

目的：建立与子代先天性心脏病（先心病）相关的35岁以下育龄期妇女非孕期时同型半胱氨酸（HCY）的风险值，为构建子代先心病一级预防的框架提供科学依据。方法：选取180例先心病患儿母亲（病例组）和180例子代为正常儿童母亲（对照组），检测两组血清中HCY、叶酸和VB₁₂浓度并进行统计学分析，绘制受试者工作特征曲线（ROC曲线）制定非孕期女性HCY风险值。结果：先心病患儿母亲平均HCY浓度为（10.48±3.34）μmol·L^-1，对照组为（8.48±2.53）μmol·L^-1，两者差异有统计学意义（P<0.05）。两组间叶酸和VB₁₂浓度差异无统计学意义（P>0.05）。通过绘制ROC曲线，确定HCY诊断临界值为8.9 μmol·L^-1，此时诊断敏感度为70.00%，特异性为65.00%。结论：与子代先心病相关的育龄期妇女非孕期时HCY风险值为8.9 μmol·L^-1，可据此进一步制定个性化的叶酸增补方案，做好出生缺陷一级预防。

Objective:To establish the risk value of homocysteine(HCY) associated with offspring congenital heart disease(CHD) in non-pregnant women under 35 years of age for providing a scientific evidence for primary prevention. Methods:A total of 180 mothers of CHD children and 180 mothers of normal children were tested for serum HCY, folic acid and VB₁₂ concentrations. ROC curves were drawn to determine the risk of HCY. Results:The average HCY concentration of the mothers with CHD children was (10.48±3.34)μmol·L^-1, and the control group was (8.48±2.53)μmol·L^-1, and the difference was statistically significant (P< 0.05). There was no statistically significant difference in the concentrations of folic acid and VB₁₂ between the two groups. By plotting the ROC curve, the critical value of HCY diagnosis was 8.9 μmol·L^-1, with a diagnostic sensitivity of 70% and a specificity of 65%. Conclusion:We have established a risk value of HCY in childbearing age women related to offspring CHD. A personalized folic acid supplementation program can be further developed for primary prevention of birth defects.

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