2023 年第 4 期 第 18 卷

孕期维生素D营养状况与子痫前期发病时间的相关性分析

Correlation analysis of vitamin D nutritional status during pregnancy and onset time of preeclampsia

作者：隋霜张艳梅黄莺

英文作者：Sui Shuang Zhang Yanmei Huang Ying

单位：新疆维吾尔自治区人民医院产科，乌鲁木齐830001

英文单位：Department of Obstetrics People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830001 China

关键词：子痫前期；维生素D；辅助性T细胞

英文关键词：Preeclampsia;VitaminD;HelperTcell

• 摘要：

• 目的 探讨孕期维生素D营养状况与子痫前期发病时间的相关性。方法 选取2020年1—12月在新疆维吾尔自治区人民医院定期产检并分娩或终止妊娠的维吾尔族子痫前期孕妇88例，按发病时间分为早发型子痫前期组（发病孕周＜34周，34例）和晚发型子痫前期组（发病孕周≥34周，54例）。选择同一时期在新疆维吾尔自治区人民医院定期产检并足月分娩的年龄、孕次与子痫前期孕妇匹配的正常孕妇87例为对照组。检测3组孕妇血清25-羟基维生素D3［25-(OH)D3］和辅助性T细胞1（Th1）/Th2/Th17细胞因子水平。分析孕妇血清25-(OH)D3水平与各细胞因子的相关性。结果 对照组、晚发型子痫前期组、早发型子痫前期组血清25-(OH)D3水平分别为（18±8）、（14±3）、（12±4）μg/L。早发型子痫前期组和晚发型子痫前期组血清25-(OH)D3水平均低于对照组（均P＜0.05），而早发型子痫前期组和晚发型子痫前期组血清25-(OH)D3水平比较差异无统计学意义（P＞0.05）。3组孕妇血浆白细胞介素6（IL-6）、IL-17a水平差异有统计学意义（均P＜0.05），而血浆IL-2、IL-4、IL-10、肿瘤坏死因子α和γ干扰素水平比较差异均无统计学意义（均P＞0.05）。早发型子痫前期孕妇的血清25-(OH)D3水平与IL-6水平呈负相关（r=-0.707，P=0.001）。结论 孕期维生素D缺乏和子痫前期的发生具有相关性，可能由于维生素D缺乏导致其免疫调节功能减弱，促炎因子IL-6释放增多，免疫失衡，导致子痫前期特别是早发型子痫前期的发生。

• Objective To investigate the correlation between vitamin D nutritional status during pregnancy and onset time of preeclampsia(PE). Methods From January to December 2020, 88 Uyghur women with PE who were regularly checked and delivered or terminated pregnancy in People′s Hospital of Xinjiang Uygur Autonomous Region were enrolled. They were divided into early onset PE group (34 cases, with onset less than 34 weeks of pregnancy) and late onset PE group (54 cases, with onset more than 34 weeks of pregnancy) according to the onset time. Another 87 normal pregnant women matched with women with PE in terms of age, pregnancy times and term delivery in the hospital were selected as the control group. The levels of serum 25-hydroxy vitamin D3 ［25-(OH)D3］ and helper T cell 1(Th1)/Th2/Th17 cytokines in pregnant women of the three groups were detected. The correlation of serum 25-(OH)D3 level of pregnant women to various cytokines were analyzed. Results The serum 25-(OH)D3 levels in the control group, late onset PE group and early onset PE group were (18±8), (14±3) and (12±4)μg/L respectively. The serum 25-(OH)D3 levels in the early onset PE group and late onset PE group were lower than that in the control group (both P＜0.05), but there was no significant difference between the early onset PE group and late onset PE group (P＞0.05). The levels of plasma interleukin-6 (IL-6) and IL-17a were significantly different among the three groups (all P＜0.05), while the levels of plasma IL-2, IL-4, IL-10, tumor necrosis factor-α and interferon-γ had no significant difference among the three groups (all P＞0.05). The serum 25-(OH)D3 level was negatively correlated with IL-6 in early onset PE women (r=-0.707, P=0.001). Conclusions  Vitamin D deficiency during pregnancy is related to PE. Vitamin D deficiency may lead to the weakening of its immune regulation function, the increased release of pro-inflammatory factor IL-6 and immune imbalance, leading to the occurrence of PE, especially early onset PE.