郑明阳　孟晓东

【摘要】 目的：探討血清25-羟基维生素D3水平在子痫前期患者中的临床意义。方法：选取2016年10月-2017年10月在抚顺市中心医院产检及就诊的子痫前期孕妇143例作为研究对象，根据病情的严重程度将其分为轻度子痫前期组（n=47）和重度子痫前期组（n=96）。另外，选取同期本院产检的正常孕妇800例作为对照组。使用液相串联质谱法测定三组孕妇孕早、晚期的血清25-羟基维生素D3水平，以及观察血清钙水平。结果：重、轻度子痫前期两组的25-羟基维生素D3水平与对照组比较均显著降低，差异均有统计学意义（t=8.900 5、5.490 2，P<0.05）。轻、重度子痫前期两组的血清钙水平与对照组比较均显著降低，差异均有统计学意义（t=10.944 6、21.211 2，P<0.01）；且重度子痫前期组明显低于轻度子痫前期组，差异有统计学意义（t=3.642 3，P<0.05）。孕早期，重度子痫前期组的25-羟基维生素D3水平与对照组比较显著降低，差异有统计学意义（t=6.022 7，P<0.01）；但轻度子痫前期组与对照组比较，差异无统计学意义（t=2.716 4，P>0.05）。孕晚期，重、轻度子痫前期两组的25-羟基维生素D3水平与对照组比较均显著降低，差异均有统计学意义（t=8.900 5、5.490 2，P<0.05）。结论：25-羟基维生素D3水平与子痫前期的发生之间具有一定的相关性。

【关键词】 妊娠期高血压疾病； 子痫前期； 25-羟基维生素D3； 血钙

Clinical Significance of 25-hydroxyvitamin D3 Detection in Patients with Preeclampsia/ZHENG Mingyang，MENG Xiaodong.//Medical Innovation of China，2018，15（27）：127-131

【Abstract】 Objective：To investigate the clinical significance of 25-hydroxyvitamin D3 in patients with preeclampsia.Method：A total of 143 pregnant women with preeclampsia in Fushun central hospital who were received birth control and treatment from October 2016 to October 2017 were selected as subjects.According to the severity of the disease，they were divided into mild preeclampsia group （n=47） and severe preeclampsia group （n=96）.In addition，800 normal pregnant women in the same period were selected as control group.The serum levels of 25-hydroxyvitamin D3 were measured by liquid chromatography tandem mass spectrometry and serum calcium were observed in the early and late pregnant women.Result：The levels of 25-hydroxyvitamin D3 in severe and mild preeclampsia groups were significantly lower than those in the control group，the differences were statistically significant （t=8.900 5，5.490 2，P<0.05）.The levels of serum calcium in severe and mild preeclampsia groups were significantly lower than those in the control group，the differences were statistically significant （10.944 6，21.211 2，P<0.01）；and severe preeclampsia group was significantly lower than that of mild preeclampsia group，the difference was statistically significant （t=3.642 3，P<0.05）.In early pregnancy，the level of 25-hydroxyvitamin D3 in severe preeclampsia group was significantly lower than that in control group，the difference was statistically significant （t=6.0227，P<0.01）；but mild preeclampsia group was not significantly different from that in control group （t=2.716 4，P>0.05）.The levels of 25-hydroxyvitamin D3 in the late pregnancy，severe and mild preeclampsia groups were significantly lower than those in the control group，the differences were statistically significant （t=8.900 5，5.490 2，P<0.05）.Conclusion：There is a correlation between the levels of 25-hydroxyvitamin D3 and the occurrence of preeclampsia.

【Key words】 Hypertensive disorders complicating pregnancy； Preeclampsia； 25-hydroxyvitamin D3；Serum calcium

First-authors address：Fushun Central Hospital，Fushun 113006，China

doi：10.3969/j.issn.1674-4985.2018.27.034

妊娠期高血壓疾病（hypertensive disorders complicating pregnancy，HDCP）是妊娠期特有的疾病，我国发病率为5%～12%，全球因其造成的孕产妇死亡数约占孕产妇死亡总数的10%～16%[1-2]。严重影响母婴健康，是孕产妇死亡的第二位原因[3]。目前认为，子痫前期是妊娠期高血压疾病的核心，其确切病因及发病机制尚不明确，来自美、德等国的大样本研究资料支持血清25-羟基维生素D水平与高血压发病间呈负相关关系。近年来，由于维生素D检测技术的改进，孕妇维生素D缺乏引起国内外研究者的关注。而血清25-羟基维生素D水平与妊娠期高血压疾病是否具有相关性，尚需进一步研究。本研究探讨了血清25-羟基维生素D3水平在子痫前期患者中的临床意义，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年10月-2017年10月在抚顺市中心医院产检及就诊的子痫前期孕妇143例作为研究对象，根据病情的严重程度将其分为轻度子痫前期组（n=47）和重度子痫前期组（n=96）。……