同型半胱氨酸与不良妊娠结局的关系

doi:10.12280/gjszjk.20200737

摘要/Abstract

摘要：

同型半胱氨酸（homocysteine,HCY）是蛋氨酸代谢的中间产物,HCY水平升高是心脑血管疾病的独立危险因素。不良妊娠为临床妊娠疾病的一种类型,随着生活环境的改变,发生率逐年升高,但相关发病机制尚不明确。近年研究发现,HCY水平与一系列不良妊娠的发生密切相关,妊娠期女性HCY水平较妊娠前明显下降,对HCY损伤敏感性增强,其水平轻度升高可能导致一系列的血管损害,进而引起一系列不良妊娠的发生。相关酶异常、辅助因子缺乏、蛋氨酸摄入过多、某些疾病和某些药物的摄入是HCY水平升高的主要原因,降低HCY水平可有效改善不良妊娠发生,合理补充叶酸、B族维生素及生活方式干预是控制HCY水平、预防和治疗不良妊娠的有效措施。综述HCY与不良妊娠结局关系,以期为不良妊娠的预防和治疗提供有益参考。

关键词: 高半胱氨酸, 高同种半胱氨酸血症, 妊娠结局, 流产, 自然, 高血压, 妊娠性, 糖尿病, 妊娠, 胎盘早剥, 治疗

Abstract:

Homocysteine (HCY) is an intermediate product of methionine metabolism. The elevated HCY level is an independent risk factor of cardiovascular and cerebrovascular diseases. Adverse pregnancy is a type of clinical pregnancy diseases. With the change of living environment, the incidence increases year by year. However, the relevant pathogenesis of adverse pregnancy is not clear. In recent years, studies have found that the level of HCY is closely related to the occurrence of a series of adverse pregnancies. The level of HCY in pregnant women is significantly lower than that before pregnancy, and the sensitivity to HCY injury is also enhanced in pregnant women. A slight increase in the level of HCY may lead to a series of vascular damage, and then lead to the occurrence of a series of adverse pregnancies. The major causes of HCY increase are the abnormal levels of enzymes related to HCY production, lack of cofactors, excessive intake of methionine, some diseases and some drugs. The decrease in the HCY level can effectively improve adverse pregnancy, by the reasonable supplement of folic acid and B vitamins and the lifestyle intervention. In this paper, the relationship between HCY and adverse pregnancy outcomes is reviewed in order to provide useful reference for the prevention and treatment of adverse pregnancy.

Key words: Homocysteine, Hyperhomocysteinemia, Pregnancy outcomes, Abortion, spontaneous, Hypertension, pregnancy-induced, Diabetes, gestational, Abruptio placentae, Therapy

申路路, 赵志梅. 同型半胱氨酸与不良妊娠结局的关系[J]. 国际生殖健康/计划生育, 2021, 40(4): 339-343.

SHEN Lu-lu, ZHAO Zhi-mei. Relationship between Homocysteine and Adverse Pregnancy Outcomes[J]. Journal of International Reproductive Health/Family Planning, 2021, 40(4): 339-343.

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