孕中期维生素D水平与孕产妇压力性尿失禁的相关性研究-现代医学

孕中期维生素D水平与孕产妇压力性尿失禁的相关性研究

单位：1. 南京医科大学公共卫生学院, 江苏南京 210000;
2. 南京医科大学附属妇产医院/南京市妇幼保健院检验科, 江苏南京 210000;
3. 南京医科大学附属妇产医院/南京市妇幼保健院妇女保健科, 江苏南京 210000;
4. 溧水区妇幼保健院孕产保健部, 江苏南京 211299

关键词：血清25-羟维生素D 孕中期产后压力性尿失禁

分类号：R714.6;R173

出版年·卷·期（页码）：2021·49·第十二期（1379-1383）

摘要：

目的： 探讨孕中期血清25羟维生素D[25（OH）D]水平与孕产妇压力性尿失禁（SUI）的相关性。方法： 选择孕24~28周孕妇SUI患者51例，同期非SUI对照46例。收集产妇一般资料，同时检测孕中期血清25（OH）D水平，分析其与孕期、产后SUI发生的相关性。结果： 孕期SUI组血清25（OH）D水平低于对照组，差异有统计学意义[（51.35±14.54）nmol·L^-1vs.（57.40±12.61）nmol·L^-1，P=0.03]；轻度SUI组血清25（OH）D水平为（54.55±14.83）nmol·L^-1，中度SUI组血清25（OH）D水平为（48.50±13.94）nmol·L^-1，差异无统计学意义（P>0.05）；选取孕中期血清25（OH）D值59.45 nmol·L^-1为预测孕期SUI的截断值，受试者工作特征（ROC）曲线的曲线下面积为0.68（P=0.01），灵敏度为76.47%，特异度为47.83%。在阴道分娩的产妇中，产后SUI组孕中期血清25（OH）D水平低于产后对照组，但差异无统计学意义（P>0.05），而产后SUI缓解组孕中期血清25（OH）D显著低于产后对照组（P<0.05）。结论： 孕中期血清维生素D水平低可能与孕期SUI的发生相关，但与产后SUI间未发现有直接关系，血清维生素D水平和产后SUI间的关系还有待进一步研究。

Objective: To explore the correlation between second trimester serum 25 hydroxyvitamin D[25(OH)D] level and stress urinary incontinence in women during pregnancy and postpartum. Methods: 51 pregnant women with SUI at 24-28 weeks of gestation and 46 controls were selected. The general clinical data were collected and the second trimester serum 25(OH)D level were detected to analyze its correlation with SUI. Results: The second trimester serum 25(OH)D in SUI group was lower than that in control group, and the difference was statistically significant[(51.35±14.54)nmol·L^-1vs.(57.40±12.61)nmol·L^-1,P<0.05]. The serum 25(OH)D level of the mild SUI group was (54.55±14.83) nmol·L^-1, and that of the moderate SUI group was(48.50±13.94) nmol·L^-1, the difference was not statistically significant (P>0.05). 59.45 nmol·L^-1 of second trimester serum 25(OH)D was selected as the cut off value for predicting pregnancy SUI. The area under curve (AUC) of the receiver operating characteristic (ROC) curve of second trimesters serum 25(OH)D for the diagnosis of pregnancy SUI was 0.68(P=0.01), the sensitivity was 76.47%, and the specificity was 47.83%. In women with vaginal delivery, the second trimesters serum 25(OH)D level of postpartum SUI group was lower than that of postpartum control group, but there was no significant difference(P>0.05), while that of postpartum remission group was lower than that of postpartum control group (P<0.05). Conclusion: Low second trimester serum vitamin D level may be associated with SUI during pregnancy, but no direct relationship has been found with postpartum SUI, and the relationship between serum vitamin D level and postpartum SUI remains to be further explored.

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