目的 分析常规围产保健下妊娠早、中、晚期血清维生素A及维生素E水平及相关影响因素,指导孕妇妊娠期合理补充维生素,提高围产保健质量.方法 收集2013年10月至2017年8月在清华大学第一附属医院及北京市第一中西医结合医院正常围产保健的孕妇妊娠早、中、晚期血清样本共5402份,采用高效液相色谱法定量测定血清维生素A及维生素E的浓度.结果 维生素A的血清水平在孕中期最高,孕晚期下降明显,维生素E的血清水平在孕早、中、晚期呈逐渐上升趋势;对维生素A水平有影响的因素是孕前体重(标准化偏回归系数= —0.047,P=0.001)、居住现状(标准化偏回归系数=0.008,P=0.03)、妊娠呕吐(标准化偏回归系数=0.03,P=0.045),其中妊娠呕吐对维生素A的影响最大;对维生素 E水平有影响的因素是居住现状(标准化偏回归系数=0.029,P=0.05)、先兆流产(标准化偏回归系数=0.033,P=0.021),其中先兆流产对维生素E的影响最大.结论 妊娠早、中、晚期血清维生素 A及维生素E水平有差别;妊娠呕吐会使维生素A的血清水平下降,应加强维生素A的补充;孕前体重低于50kg及有先兆流症状者更需要补充维生素E;流动人口中的孕妇,血清维生素A及维生素E均偏低,故更应做好二者的摄入补充.%Objective To analyze the serum levels of vitamin A and E of pregnant women in early,middle and late pregnancy under conventional perinatal health care and their related factors,and to guide the rational vitamin supplements during pregnancy and to promote perinatal health care quality.Methods Altogether 5 402 serum samples getting in early,middle and late pregnancy of pregnant women receiving normal perinatal health care in First Affiliated Hospital of Tsinghua University and Beijing First Integrated Traditional Chinese and Western Medicine Hospital from October 2013 to August 2017 were collected.Concentrations of serum vitamin A and E were quantitatively detected by using high performance liquid chromatography(HPLC)method.Results Serum level of vitamin A was highest in middle stage of pregnancy,and it decreased in late stage of pregnancy obviously.Serum level of vitamin E showed a gradual increasing trend in early,middle and late stage of pregnancy.Factors affecting vitamin A level were preconception weight(standardized partial regression coefficient = — 0.047, P = 0.001),current status of residence (standardized partial regression coefficient =0.008,P=0.03)and pregnancy vomiting(standardized partial regression coefficient =0.03,P=0.045),among which pregnancy vomiting had greatest influence on vitamin A level.Factors affecting vitamin E level were status of residence(standardized partial regression coefficient =0.029,P=0.05)and threatened abortion(standardized partial regression coefficient=0.033,P=0.021),in which threatened abortion had greatest effect on vitamin E level.Conclusion There are differences in serum vitamin A and E levels in early,middle and late pregnancy.Vomiting in pregnancy can reduce serum level of vitamin A,and vitamin A supplementation should be strengthened.Those whose weight less than 50kg before pregnancy and have threatened abortion should take vitamin E supplement.Pregnant women in floating population have low serum levels of both vitamin A and E,so they should supplement both vitamins.
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