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分娩前静脉血铬水平与子痫前期的病例对照研究

李汪俊,  李金波,  郭孟竹,  任庆文,  冯永亮,  杨海澜,  张亚玮,  王素萍,  邬惟为

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文章导航 > 中华疾病控制杂志  > 2022 >  26(7): 798-802
李汪俊, 李金波, 郭孟竹, 任庆文, 冯永亮, 杨海澜, 张亚玮, 王素萍, 邬惟为. 分娩前静脉血铬水平与子痫前期的病例对照研究[J]. 中华疾病控制杂志, 2022, 26(7): 798-802. doi: 10.16462/j.cnki.zhjbkz.2022.07.009
引用本文: 李汪俊, 李金波, 郭孟竹, 任庆文, 冯永亮, 杨海澜, 张亚玮, 王素萍, 邬惟为. 分娩前静脉血铬水平与子痫前期的病例对照研究[J]. 中华疾病控制杂志, 2022, 26(7): 798-802. doi: 10.16462/j.cnki.zhjbkz.2022.07.009
shu
LI Wang-jun, LI Jin-bo, GUO Meng-zhu, REN Qing-wen, FENG Yong-liang, YANG Hai-lan, ZHANG Ya-wei, WANG Su-ping, WU Wei-wei. A case-control study of venous blood chromium levels before delivery and preeclampsia[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(7): 798-802. doi: 10.16462/j.cnki.zhjbkz.2022.07.009
Citation: LI Wang-jun, LI Jin-bo, GUO Meng-zhu, REN Qing-wen, FENG Yong-liang, YANG Hai-lan, ZHANG Ya-wei, WANG Su-ping, WU Wei-wei. A case-control study of venous blood chromium levels before delivery and preeclampsia[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(7): 798-802. doi: 10.16462/j.cnki.zhjbkz.2022.07.009
shu

分娩前静脉血铬水平与子痫前期的病例对照研究

doi: 10.16462/j.cnki.zhjbkz.2022.07.009
  • 1.

    030001 太原，山西医科大学公共卫生学院流行病学教研室

  • 2.

    030001 太原，山西医科大学第一医院妇产科

  • 3.

    100021 北京，国家癌症中心，国家肿瘤临床研究中心，中国医学科学院北京协和医学院肿瘤医院

基金项目: 

国家自然科学基金 81703314

山西省高等学校科技创新项目 2019L0439

山西省留学人员科技活动择优资助项目 20210042

详细信息
    通讯作者:

    邬惟为，E-mail：wuweiwei2008@sina.com

  • 中图分类号: R714.24

A case-control study of venous blood chromium levels before delivery and preeclampsia

  • 1.

    Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China

  • 2.

    Obstetrics and Gynecology, First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China

  • 3.

    National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Funds: 

National Natural Science Foundation of China 81703314

Scientific and Technological Innovation Project of Higher Education Institutions in Shanxi Province 2019L0439

Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province 20210042

More Information

    摘要
  • 摘要:   目的  探讨分娩前静脉血铬(chromium, Cr)水平与孕妇子痫前期(preeclampsia, PE)及其临床亚型的发生风险的关系。  方法  研究对象为2012年3月―2016年9月在山西医科大学第一医院产科住院分娩的孕妇，从中随机选取442例PE病例[195例早发型子痫前期(early-onset PE, EOPE)和247例晚发型子痫前期(late-onset PE, LOPE)]和1 745例正常妊娠孕妇。收集其一般人口学特征、疾病史、家族史等，以及检测其全血中的重金属Cr浓度。经非条件Logistic回归分析模型分析Cr暴露对PE及其临床亚型的发生风险的影响。  结果  PE组孕妇全血Cr暴露水平为[9.54(3.40, 39.26)]μg/L，其中EOPE组为[9.75(3.56, 55.38)] μg/L，LOPE组为[9.36(3.21, 39.24)] μg/L，均高于与正常妊娠孕妇的[7.02(0.10, 30.05)] μg/L(均有P＜0.05)。经非条件Logistic回归分析，调整孕妇年龄、文化程度、家庭人均月收入等混杂因素后，Cr暴露与PE及其临床亚型的发生风险均有关，且对EOPE影响更大。  结论  妊娠Cr暴露与PE的发生风险有关，并与EOPE的发病风险关联更大。
    Abstract:   Objective  To investigate the relationship between chromium (Cr) exposure during pregnancy and the risk of preeclampsia (PE) and its clinical subtypes.  Methods  The research subjects were pregnant women who gave birth in the Obstetrics department of the First Hospital of Shanxi Medical University from March 2012 to September 2016. A total of 442 cases of PE [195 cases of early-onset PE (EOPE) and 247 cases of late-onset PE (LOPE)] and 1 745 normal pregnant women were randomly selected. The general demographic characteristics, disease history, family history, etc. were collected, and the concentration of heavy metal Cr in whole blood was detected. Unconditional Logistic regression was used to analyze the level of Cr exposure and the risk of PE and its clinical subtypes.  Results  The whole blood Cr exposure level of pregnant women in the PE group was [9.54 (3.40, 39.26)] μg/L, that in the EOPE group was [9.75 (3.56, 55.38)] μg/L, and that in the LOPE group was [9.36 (3.21, 39.24)] μg/L, which were higher than that of normal pregnant women with [7.02 (0.10, 30.05)] μg/L (all P < 0.05). Using unconditional Logistic regression analysis, after adjusting for confounding factors such as pregnant women's age, education level, and per capita monthly income, Cr exposure levels were related to the risk of PE and its different clinical subtypes, and it was associated with a higher risk of EOPE.  Conclusion  Cr exposure in pregnancy is related to the risk of PE, and is more related to the risk of EOPE.
    • HTML全文

  • 表  1  PE组和对照组孕妇基本特征比较[n(%)]

    Table  1.   Comparison of basic characteristics of pregnant women in PE and control groups [n(%)]

    变量 总人数(N=2 187) PE组(n=442) 对照组(n=1 745) χ2值 P值
    孕妇年龄(岁) 47.23 < 0.001
       < 25 241 (11.02) 89 (20.14) 152 (8.71)
      25~ < 35 1 575 (72.02) 282 (63.80) 1 293 (74.10)
      ≥35 371 (16.96) 71 (16.06) 300 (17.19)
    文化程度 126.76 < 0.001
      初中及以下 468 (21.40) 169 (38.24) 299 (17.13)
      高中/中专/大专 733 (33.52) 164 (37.10) 569 (32.61)
      大学及以上 986 (45.08) 109 (24.66) 877 (50.26)
    家庭人均月收入(元) 42.01 < 0.001
       < 2 000 399 (18.24) 118 (26.70) 281 (16.10)
      2 000~ < 4 000 1 231 (56.29) 254 (57.46) 977 (55.99)
      ≥4 000 557 (25.47) 70 (15.84) 487 (27.91)
    孕前BMI (kg/m2) 48.31 < 0.001
       < 18.5 294 (13.44) 40 (9.05) 254 (14.56)
      18.5~ < 24 1 378 (63.01) 244 (55.20) 1 134 (64.98)
      ≥24 515 (23.55) 158 (35.75) 357 (20.46)
    孕期增重 61.77 < 0.001
      不足 387 (17.70) 55 (12.44) 332 (19.02)
      适宜 803 (36.71) 112 (25.34) 691 (39.60)
      过多 997 (45.59) 275 (62.22) 722 (41.38)
    孕期体育活动(h/d) 6.75 0.034
       < 7 695 (31.78) 161 (36.42) 534 (30.60)
      7~ < 10 820 (37.49) 163 (36.88) 657 (37.65)
      ≥10 672 (30.73) 118 (26.70) 554 (31.75)
    高血压家族史 18.36 < 0.001
      是 349 (15.96) 100 (22.62) 249 (14.27)
      否 1 838 (84.04) 342 (77.38) 1 496 (85.73)
    妊娠期糖尿病 55.01 < 0.001
      是 764 (34.93) 88 (19.91) 676 (38.74)
      否 1 423 (65.07) 354 (80.09) 1 069 (61.26)
    糖尿病家族史 0.59 0.444
      是 183 (8.37) 33 (7.47) 150 (8.60)
      否 2 004 (91.63) 409 (92.53) 1 595 (91.40)
    产次 1.23 0.268
      初产 1 146 (52.40) 242 (54.75) 904 (51.81)
      经产 1 041 (47.60) 200 (45.25) 841 (48.19)
    孕期被动吸烟a 4.28 0.040
      是 300 (13.72) 74 (16.74) 226 (12.95)
      否 1 887 (86.28) 368 (83.26) 1 519 (87.05)
    注：a被动吸烟：指孕妇每周至少吸一次二手烟，每次持续时间＞30 min。
    下载: 导出CSV

    表  2  Cr在PE、EOPE、LOPE和对照组中的基本情况[M (P25, P75)]

    Table  2.   Basic conditions of Cr in PE, EOPE, LOPE and control groups [M (P25, P75)]

    金属 对照组(n=1 745) PE组(n=442) EOPE组(n=195) LOPE组(n=247)
    Cr(μg/L) 7.02 (0.10, 30.05) 9.54 (3.40, 39.26) a 9.75 (3.56, 55.38) a 9.36 (3.21, 39.24) a
    注：a与对照组比较，差异有统计学意义(P < 0.05)。
    下载: 导出CSV

    表  3  PE、EOPE、LOPE和对照组Cr内暴露水平的定性比较[n(%)]

    Table  3.   Qualitative comparison of Cr exposure levels in PE, EOPE, LOPE and control groups [n(%)]

    Cr (μg/L) 对照组(n=1 745) PE组(n=442) EOPE组(n=195) LOPE组(n=247)
    Q1 (< 2.50) 582 (33.35) 92(20.82) 38 (19.49) 54 (21.86)
    Q2 (2.50~ < 15.37) 581 (33.30) 191(43.21) 89 (45.64) 102 (41.30)
    Q3 (≥15.37) 582 (33.35) 159(35.97) 68 (34.87) 91 (36.84)
    下载: 导出CSV

    表  4  Cr内暴露水平对PE及其临床亚型影响因素的非条件Logistic回归分析

    Table  4.   Unconditional Logistic regression analysis of the influencing factors of Cr exposure levels on PE and PE clinical subtypes

    Cr (μg/L) PE EOPE LOPE
    OR (95% CI)值 OR (95% CI)值a OR (95% CI)值 OR(95% CI)值a OR(95% CI)值 OR(95% CI)值a
    Q1 (< 2.50) 1.00 1.00 1.00 1.00 1.00 1.00
    Q2 (2.50~ < 15.37) 2.08(1.58~2.74) 2.02(1.50~2.72) 2.35 (1.58~3.49) 2.33 (1.53~3.54) 1.89(1.33~2.68) 1.88(1.29~2.73)
    Q3 (≥15.37) 1.73(1.31~2.29) 1.73(1.28~2.35) 1.79 (1.18~2.71) 1.74 (1.12~2.70) 1.69 (1.18~2.40) 1.81 (1.23~2.65)
    注：a调整因素为孕妇年龄、文化程度、家庭人均月收入、孕前BMI、孕期增重、体育活动、妊娠期糖尿病、高血压家族史、孕期被动吸烟。
    下载: 导出CSV
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  • 收稿日期:  2021-10-26
  • 修回日期:  2022-04-07
  • 网络出版日期:  2022-07-19
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