妊娠期血清维生素水平与子痫前期的相关性

doi:10.12280/gjfckx.20230681

摘要/Abstract

摘要：

子痫前期（preeclampsia，PE）是导致孕产妇围产期病死率升高的主要原因之一，其发病机制尚未完全明确。目前研究发现妊娠期体内多种维生素水平与PE发病有关。维生素D在PE发病过程中参与了胎盘形成、炎症反应、氧化应激和免疫激活等，其缺乏可通过以上多种机制导致PE。维生素E的水平在PE患者体内低于正常孕妇，其缺乏可能会增加PE患病风险，但具体机制尚未明确，可能与其抗氧化作用有关。维生素A的水平与PE的关系存在争议。PE发病还与同型半胱氨酸、叶酸（维生素B₉）、维生素B₁₂、维生素B₆即一碳代谢密切相关，相关维生素缺乏可导致同型半胱氨酸代谢障碍，从而引起PE。维生素B₃主要通过保护血管内皮及调节氧化还原反应而对PE产生保护作用。维生素C缺乏与PE发病相关，同时在PE患者补液治疗时应用维生素C可在一定程度上减少肺水肿的发生。

关键词: 先兆子痫, 维生素类, 氧化性应激, 免疫调节, 治疗

Abstract:

Preeclampsia (PE) is one of the main causes of increased perinatal mortality, and its pathogenesis remains unclear. The present study has found that the levels of multivitamins during pregnancy were correlated with incidence of PE. It has been proved that vitamin D is involved in placental formation, inflammatory reaction, oxidative stress and immune activation in the pathogenesis of PE. Vitamin D deficiency can lead to PE through the above mechanisms. In addition, the levels of vitamin E in patients with PE are lower than those in normal pregnant women, suggesting that the lack of vitamin E may increase the risk of PE, but the specific mechanism is still under investigation, it may be related to its antioxidant activity. The relationship between vitamin A levels and PE is controversial. PE is also associated with homocysteine, folic acid (vitamin B₉), vitamin B₁₂ and vitamin B₆, also known as carbon metabolism. The deficiency of related vitamins leads to homocysteine metabolism disorder, thus causing PE. Vitamin B₃ primarily protects against PE by preserving the endothelium and regulating redox reactions. Vitamin C deficiency is associated with PE, and the use of vitamin C during fluid replacement therapy can partially reduce the incidence of pulmonary edema.

Key words: Pre-eclampsia, Vitamins, Oxidative stress, Immunomodulation, Therapy

李杰芃, 程瑶, 刘泽君, 叶明珠, 孙国强. 妊娠期血清维生素水平与子痫前期的相关性[J]. 国际妇产科学杂志, 2024, 51(1): 5-9.

LI Jie-peng, CHENG Yao, LIU Ze-jun, YE Ming-zhu, SUN Guo-qiang. The Relationship between Serum Vitamin Level during Pregnancy and Preeclampsia[J]. Journal of International Obstetrics and Gynecology, 2024, 51(1): 5-9.

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