育龄妇女增补叶酸1．2 mg/d对红细胞叶酸水平的影响

摘要

Objective To analyze the time needed to achieve the red blood cell folate threshold of prevention of neural tube defects(NTDs) after 1. 2mg/d folic acid supplement,to put forward the rational scheme of folic acid supplement to prevent NTDs in unplanned pregnancy women. Methods 40 volunteer subjects were randomly divided into observe group and control group,each group with 20 cases. Women in observe group were supplemented with 1. 2 mg/d folic acid,and women in control group were supplement with placebo. Blood samples were extracted and red blood cell folate level were detected every 7 days for 4 weeks. Results The red blood cell folate level of observe group reached up to above 906 nmol/L after 2~3 weeks,while control group maintained 700 nmol/L after 4 weeks. Significant differences had been found between two groups in 1,2,3,4 weeks after supplement. Conclusion The unplanned pregnancy women may supplement 1. 2 mg/d folic acid for initial dose,and alter 0. 4 mg/d after 2 weeks till 3 months pregnancy. This scheme can shorten the increasing period of red blood cell folate level effectively in first trimester,and ensure the effect of NTDs prevention.%目的：研究育龄妇女增补叶酸1．2 mg/d 后红细胞叶酸水平达到预防胎儿神经管畸形( neural tube defects,NTDs)阈值所需的时间,旨在为计划外妊娠妇女提出合适的叶酸增补方案,有效预防胎儿NTDs。方法将志愿观察对象40例按随机数字法分为观察组和对照组,每组各20例。观察组的育龄妇女增补叶酸1．2 mg/d,对照组的育龄妇女以淀粉片为安慰剂。服药周期为28 d,每隔7 d抽样检测红细胞叶酸水平。结果观察组的红细胞叶酸水平在2~3周后>906 nmol/L,对照组的红细胞叶酸水平在4周后仍保持在700 nmol/L左右。两组红细胞叶酸水平在给药1、2、3、4周后差异均有统计学意义(P<0．05)。结论计划外妊娠妇女增补叶酸可考虑初始剂量为1．2 mg/d,待2周后体内红细胞叶酸浓度大幅提高,再更改为0．4 mg/d的剂量服食至孕3个月。此方案可有效缩短孕早期妇女红细胞叶酸水平提高的时间,预防胎儿NTDs。