妊娠期、产褥期妇女维生素D和PTH营养状况的评价

摘要

目的：了解妊娠期、产褥期妇女钙吸收水平和维生素D、甲状旁腺激素（PTH）的分布水平和营养状况。方法选取2014年9月至2015年11月来围产门诊就诊的孕妇和产褥期妇女共740例设为观察组，分为孕中期组、孕晚期组和产褥期组。随机抽取同期健康非孕妇女100例作为对照组。用电化学发光法检测所有研究对象血清25‐羟基维生素D（25‐OH‐D）、PTH的水平，联合检测镁（Mg）、磷（P）、碱性磷酸酶（ALP）、钙（Ca）等指标，并比较各组结果的差异。结果孕中期组妇女25‐OH‐D水平为（57．9±18．2）nmol／L，孕晚期组为（39．4±15．0）nmol／L，产褥期组为（65．1±19．6）nmol／L，对照组为（78．6±16．2）nmol／L，组间对比差异有统计学意义（P＜0．05）。PTH水平孕晚期组高于孕中期组，两组对比差异有统计学意义（P＜0．05）。血清中钙、镁、ALP水平观察组低于对照组，差异有统计学意义（P＜0．05）。结论妊娠期和产褥期妇女普遍存在低钙、低镁、维生素D不足或缺乏的现象，补钙同时补充维生素D及其他矿物质元素是必要的。%Objective To investigate the serum calcium absorption level ,distribution level and nutritional status of 25‐hydroxy vitamin D and parathyroid hormone (PT H ) in pregnant and puerperal women .Methods A total of 740 healthy pregnant women and puerperal women in the perinatal clinic of our hospital from September 2014 to August 2015 were recruited as the observation group and divided into second trimester group ,third trimester group and puerperal group .Contemporaneous 100 healthy non‐preg‐nant women were chosen as the control group .The levels of serum 25‐hydroxy vitamin D and PTH in all research subjects were de‐tected by using the electrochemiluminescence method .Then the differences of detection results were compared among various groups .Results The serum 25‐hydroxy vitamin D level was (57 .9 ± 18 .2)nmol/L in the second trimester group ,(39 .4 ± 15 .0) nmol/L in the third trimester group ,(65 .1 ± 19 .6)nmol/L in the puerperal group and (78 .6 ± 16 .2)nmol/L in the control group , the differences among groups were statistically significant (P<0 .05) .The serum PTH level in the third trimester group was higher than that in the second trimester group ,the difference between the two groups was statistically significant (P<0 .05) .Serum calci‐um ,magnesium and alkaline phosphatase levels in the observation group were lower than those in the control group with statistical‐ly significant (P<0 .05) .Conclusion Pregnant and puerperal women usually have low levels of calcium and magnesium ,and 25‐hy‐droxy vitamin D deficiency .It is necessary to supply vitamin D and other mineral elements when taking calcium supplement .