• 中国精品科技期刊
  • 《中文核心期刊要目总览》收录期刊
  • RCCSE 中国核心期刊(5/114,A+)
  • Scopus收录期刊
  • 美国《化学文摘》(CA)收录期刊
  • WHO 西太平洋地区医学索引(WPRIM)收录期刊
  • 《中国科学引文数据库(CSCD)》核心库期刊 (C)
  • 中国科技核心期刊
  • 中国科技论文统计源期刊
  • 《日本科学技术振兴机构数据库(中国)》(JSTChina)收录期刊
  • 美国《乌利希期刊指南》(UIrichsweb)收录期刊
  • 中华预防医学会系列杂志优秀期刊(2019年)

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

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. 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
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

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
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

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:   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。
  • 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 P
    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
  • [1] Liu Y, Li N, Li Z, et al. Impact of gestational hypertension and preeclampsia on fetal gender: a large prospective cohort study in China[J]. Pregnancy Hypertens, 2019, 18: 132-136. DOI: 10.1016/j.preghy.2019.09.020.
    [2] 姜停停, 万立新, 何欢, 等. 吉林省孕产妇妊娠期高血压疾病患病率及影响因素[J]. 中华疾病控制杂志, 2021, 25(11): 1287-1292. DOI: 10.16462/j.cnki.zhjbkz.2021.11.009.

    Jiang TT, Wan LX, He H, et al. Analysis on prevalence and influencing factors of hypertensive disorder complicating pregnancy among pregnant women in Jilin Province. [J]. Chin J Dis Control Prev, 2021, 25(11): 1287-1292. DOI: 10.16462/j.cnki.zhjbkz.2021.11.009.
    [3] Maduray K, Moodley J, Soobramoney C, et al. Elemental analysis of serum and hair from pre-eclamptic South African women[J]. J Trace Elem Med Biol, 2017, 43: 180-186. DOI: 10.1016/j.jtemb.2017.03.004.
    [4] Bommarito P, Kim S, Meeker J, et al. Urinary trace metals, maternal circulating angiogenic biomarkers, and preeclampsia: a single-contaminant and mixture-based approach[J]. Environ Health, 2019, 18(1): 63. DOI: 10.1186/s12940-019-0503-5.
    [5] Greene L, Riederer A, Marcus M, et al. Associations of fertility and pregnancy outcomes with leather tannery work in Mongolia: a pilot study[J]. Int J Occup Environ Health, 2010, 16(1): 60-68. DOI: 10.1179/107735210800546100.
    [6] Banu S, Stanley J, Sivakumar K, et al. Chromium Ⅵ-Induced developmental toxicity of placenta is mediated through spatiotemporal dysregulation of cell survival and apoptotic proteins[J]. Reprod Toxicol, 2017, 68: 171-190. DOI: 10.1016/j.reprotox.2016.07.006.
    [7] 杨孜, 张为远. 妊娠期高血压疾病诊治指南(2015)[J]. 中华产科急救电子杂志, 2015, 4(4): 206-213. DOI: 10.3877/cma.J.issn.2095-3259.2015.04.004.

    Yang Z, Zhang WY. Guidelines for the diagnosis and treatment of hypertension in pregnancy (2015)[J]. Chin J Obstet Emerg (Electronic Edition), 2015, 4(4): 206-213. DOI: 10.3877/cma.J.issn.2095-3259.2015.04.004.
    [8] Wang Y, Zhao N, Qiu J, et al. Folic acid supplementation and dietary folate intake, and risk of preeclampsia[J]. Eur J Clin Nutr, 2015, 69(10): 1145-1150. DOI: 10.1038/ejcn.2014.295.
    [9] Rana S, Lemoine E, Granger J, et al. Preeclampsia: pathophysiology, challenges, and perspectives[J]. Circ Res, 2019, 124(7): 1094-1112. DOI: 10.1161/CIRCRESAHA.118.313276.
    [10] Cheng H, Zhou T, Li Q, et al. Anthropogenic chromium emissions in China from 1990 to 2009[J]. PLoS One, 2014, 9(2): e87753. DOI: 10.1371/journal.pone.0087753.
    [11] Ziaee H, Daniel J, Datta A, et al. Transplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplasty: a controlled study[J]. J Bone Joint Surg Br, 2007, 89(3): 301-305. DOI: 10.1302/0301-620X.89B3.18520.
    [12] Marouani N, Tebourbi O, Mokni M, et al. Embryotoxicity and fetotoxicity following intraperitoneal administrations of hexavalent chromium to pregnant rats[J]. Zygote (Cambridge, England), 2011, 19(3): 229-235. DOI: 10.1017/S0967199410000274.
    [13] Berry M, Bove F. Birth weight reduction associated with residence near a hazardous waste landfill[J]. Environ Health Perspect, 1997, 105(8): 856-861. DOI: 10.1289/ehp.97105856.
    [14] Pan X, Hu J, Xia W, et al. Prenatal chromium exposure and risk of preterm birth: a cohort study in Hubei, China[J]. Sci Rep, 2017, 7(1): 3048. DOI: 10.1038/s41598-017-03106-z.
    [15] Padula A, Ma C, Huang H, et al. Drinking water contaminants in California and hypertensive disorders in pregnancy[J]. Environ Epidemiol, 2021, 5(2): e149. DOI: 10.1097/EE9.0000000000000149.
    [16] Andraweera P, Dekker G, Roberts C. The vascular endothelial growth factor family in adverse pregnancy outcomes[J]. Hum Reprod Update, 2012, 18(4): 436-457. DOI: 10.1093/humupd/dms011.
    [17] Burton GJ, Redman CW, Roberts J, et al. Pre-eclampsia: pathophysiology and clinical implications[J]. BMJ, 2019, 366: 2381. DOI: 10.3390/ijms22105402.
    [18] Banu SK, Stanley JA, Taylor RJ, et al. Sexually dimorphic impact of chromium accumulation on human placental oxidative stress and apoptosis[J]. Toxicol Sci, 2018, 161(2): 375-387. DOI: 10.1093/toxsci/kfx224.
    [19] Soobramoney C, Maduray K, Moodley J, et al. The screening of nails for selected essential and toxic elements in normotensive and pre-eclamptic women[J]. Biol Trace Elem Res, 2019, 189(1): 28-33. DOI: 10.1007/s12011-018-1465-0.
    [20] Jones E, Wright J, Rice G, et al. Metal exposures in an inner-city neonatal population[J]. Environ Int, 2010, 36(7): 649-654. DOI: 10.1016/j.envint.2010.04.007.
    [21] 韩文丽. 孕期系统管理与子痫前期发病率调查[J]. 河南职工医学院学报, 2007, 19(3): 252-253. DOI: 10.3969/j.issn.1008-9276.2007.03.028.

    Han WL. Systematic management during pregnancy and investigation of preeclampsia incidence[J]. Journal of Henan Medical College for Staff and Workers, 2007, 19(3): 252-253. DOI: 10.3969/j.issn.1008-9276.2007.03.028.
  • 加载中
表(4)
计量
  • 文章访问数:  24
  • HTML全文浏览量:  6
  • PDF下载量:  4
  • 被引次数: 0
出版历程
  • 收稿日期:  2021-10-26
  • 修回日期:  2022-04-07
  • 网络出版日期:  2022-07-19
  • 刊出日期:  2022-07-10

目录

    /

    返回文章
    返回