Leeda M, Riyazi N, de Vries J I, Jakobs C, van Geijn H P, Dekker G A
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
Am J Obstet Gynecol. 1998 Jul;179(1):135-9. doi: 10.1016/s0002-9378(98)70263-7.
Our purpose was to assess the incidence of hyperhomocysteinemia in patients with a history of preeclampsia or fetal growth restriction, to evaluate the effects of vitamin supplementation on the methionine loading test, and to study the course of subsequent pregnancies in women with hyperhomocysteinemia and a history of preeclampsia or fetal growth restriction.
A total of 207 consecutive patients with a history of preeclampsia or fetal growth restriction was tested for hyperhomocysteinemia. Thirty-seven were found to be positive and were treated with folic acid and vitamin B6, and 27 had a second methionine loading test after vitamin supplementation. Fourteen patients became pregnant again while receiving vitamins and aspirin.
All patients who underwent a methionine loading test after vitamin supplementation had a completely normalized methionine loading test. Of the 14 pregnancies in women receiving vitamins and aspirin, 7 were complicated by preeclampsia. Birth weights were 2867 +/- 648 g compared with 1088 +/- 570 g in the previous pregnancies.
Vitamin B6 and folic acid correct the methionine loading test in patients with hyperhomocysteinemia. Perinatal outcome in patients with a history of preeclampsia or fetal growth restriction and hyperhomocysteinemia appears to be favorable.
我们的目的是评估有子痫前期或胎儿生长受限病史的患者中高同型半胱氨酸血症的发生率，评估维生素补充对甲硫氨酸负荷试验的影响，并研究有高同型半胱氨酸血症且有子痫前期或胎儿生长受限病史的女性随后妊娠的过程。
对总共207例有子痫前期或胎儿生长受限病史的连续患者进行了高同型半胱氨酸血症检测。发现37例呈阳性，并给予叶酸和维生素B6治疗，27例在补充维生素后进行了第二次甲硫氨酸负荷试验。14例患者在接受维生素和阿司匹林治疗期间再次怀孕。
所有补充维生素后进行甲硫氨酸负荷试验的患者，其甲硫氨酸负荷试验完全恢复正常。在接受维生素和阿司匹林治疗的14例妊娠中，7例并发子痫前期。出生体重为2867±648g，而前次妊娠为1088±570g。
维生素B6和叶酸可纠正高同型半胱氨酸血症患者的甲硫氨酸负荷试验。有子痫前期或胎儿生长受限病史且有高同型半胱氨酸血症的患者围产期结局似乎良好。
