目的 比较出生缺陷高发和低发地区--山西吕梁和北京怀柔地区孕妇血清叶酸、维生素B12及其代谢产物同型半胱氨酸水平,探讨造成两地出生缺陷发生率差异的营养学因素.方法 选择吕梁地区的140名孕妇和怀柔地区的133名孕妇作为研究对象,采集研究对象的静脉血,比较两地区孕妇血清叶酸、维生素B12和同型半胱氨酸水平差异.结果 吕梁地区孕妇血清平均叶酸、维生素B12水平显著低于怀柔地区(t值分别为6.10、13.77,均P<0.05).同时吕梁地区孕妇血清同型半胱氨酸水平显著高于怀柔地区(t=15.32,P<0.05),吕梁地区叶酸、维生素B12缺乏率显著高于怀柔地区(χ2值分别为7.84、61.02,均P<0.05).结论 出生缺陷高发地区孕妇血清叶酸、维生素B12水平显著偏低,叶酸相关一碳单位代谢水平异常在一定程度上解释了高出生缺陷发生率的原因.%Objective To explore the nutritional factors that affect the difference in prevalence of birth defects between Lvliang in Shanxi with high prevalence and Huairou in Beijing with low prevalence by comparing the serum levels of folio acid ( FA ), vitamin B12( VitB12 )and homooysteine ( Hcy ) of pregnant women in these two areas. Methods One hundred and forty pregnant women in Lvliang and 133 pregnant women in Huairou were recruited. Their serum levels of FA, VitB12 and Hcy were analyzed and compared. Results The average levels of FA and VitB12 of pregnant women in Lvliang were significantly lower than those in Huairou ( t was 6.10 and 13.77 respectively,P ＜ 0.05 ), but the average serum level of Hcy in Lvliang was significantly higher ( t= 15.32, P ＜ 0.05 ). The deficiency rate of FA and VitB12 in Lvliang was significantly higher than that in Huairou (X2 was 7.84 and 61.02 respectively, P ＜ 0.05 ). Conclusion The serum levels of FA and VitB12in pregnant women are significantly low in the area where the prevalence of birth defects is high. The disorder of folate-related one-carbon unit metabolism accounts for the high prevalence of birth defects to some extent.
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