请问关于孕妇服用叶酸的好处与禁忌

请问关于孕妇服用叶酸的好处与禁忌 请问关于孕妇服用叶酸的好处与禁忌 悬赏分:100 - 解决时间:2006-9-3 16:12 我老婆已经怀孕三个月(大约2006年6月10日左右)了，在2005年8-9月份曾经怀孕过，后来孩子被诊断是脑积水，就做掉了，心好疼，这次怀孕很想保住，最近去医院检查虽然一切正常，但是心里还是很担心，咨询了一下，说是吃叶酸对防止婴儿畸形有效果，我想向各位有识之士咨询一下，叶酸的服用方法和它的好处与禁忌是什么，希望有用过的姐姐或者懂这方面知识的前辈们给我讲解一下，我真的不想再看到心爱的人再痛苦了，谢谢了，保证追加100分，再次跪谢～~ 问题补充:还有关于叶酸的用法与用量，服用时间等等相关的问题，请给我个详细点的谢谢～~ 提问者: 307568085 - 魔法师 四级 最佳答案背景知识: 叶酸是一种水溶性 B 族维生素，对细胞的分裂生长及核酸、氨基酸、蛋白质的合成起着重要的作用，也是胎儿生长发育不可缺少的营养素。 准备生育的新婚女性，从婚前就应注意补充充足的叶酸，因为妊娠早期若缺乏叶酸，会使胎儿神经髓鞘与构成传递神经冲动介质的原料匮乏，影响胎儿大脑与神经管的发育，造成神经管畸形，严重者可致脊柱裂或无脑儿等先天畸形。 红苋菜、菠菜、生菜、芦笋、龙须菜、油菜、小白菜、花椰菜、 球芽甘蓝 、豆类、酵母、麦皮面包、动物肝、麦芽及香蕉、草莓、橙子等食物都是叶酸绝佳来源。 美国营养学家推荐孕妇每天吃一只香蕉，因为就 香蕉复含叶酸 、维生素 B6 及钾、镁等物质。必要时每天服用400 微克叶酸，一直到妊娠开始3个月.美国加州研究所人员发现，若在妇女孕前和怀孕开始 1,2 个月期间每天补充 400 微克叶酸，可使胎儿兔唇和腭裂缺陷的发生率降低 25 , ―50 ,。 我国学者发现妇女怀孕早期体内叶酸缺乏是儿童先天性心脏病发生的原因之一，若母亲孕前早期 3 个月内每天补充 400 微克叶酸，可能减少 35.5 ,的先天性心脏病发生。 1.剂量与后遗症: 妇女怀孕前三个月到怀孕后三个月期间，每天服用O.4毫克的叶酸增补剂可以预防胎儿大部分神经管畸形的发生。 缺乏最直接的后果是可以导致胎儿神经管畸形。所以怀孕前就开始服用叶酸是为了使妇女体内的叶酸维持在一定的水平，以保证胚胎早期有一个较好的叶酸营养状态，而怀孕后的前三个月都属于胎儿神经管形成的敏感期，坚持服用才能起到最好的预防效果。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 专家也提醒，孕妇若在孕早期大剂量服用的叶酸片，可能对孕妇本人和胎儿产生不良的影响。所以孕期切忌自己滥用药物，即使同一种药物也应分清剂型。 妇女服用叶酸应在医生指导下进行，另外，还需注意以下几点: 1 、必须从怀孕前一个月开始服用。强调怀孕前就要开始服用的目的是为使妇女体内的叶酸维持在一定的水平，以保证胚胎早期有一个较好的叶酸营养状态。据研究，妇女在服用叶酸后要经过 4 周的时间，体内叶酸缺乏的状态才能得以纠正。这样在怀孕早期胎儿神经管形成的敏感期中，足够的叶酸才能满足神经系统发育的需要，而且要在怀孕后的前三个月敏感期中坚持服用才能起到最好的预防效果。 2 、不要用“叶酸片”代替“小剂量叶酸增补剂”。叶酸增补剂每片中仅含 0.4 毫克叶酸，是国家批准的惟一预防药品(商品名称为“斯利安”)。而市场上有一种 供治疗 贫血用的“叶酸片”，每片含叶酸 5 毫克，相当于“斯利安”片的 12.5 倍。孕妇在孕早期切忌服用这种大剂量的叶酸片，因为长期大剂量服用叶酸片对孕妇和胎儿会产生不良的影响。因此提醒孕妇要听从医生和保健人员的指导，切忌自己滥服药、乱买药。 【主要作用】 1、预防胎儿神经管畸形(无脑畸形、脊柱裂)，斯利安叶酸片 有效率达85,。 2、预防胎儿唇腭裂，有效率50,。 3、预防胎儿先心病、其他体表畸形等出生缺陷。 4、预防孕妇、乳母及胎儿贫血。 5、促进胎儿神经系统发育。 6、降低婴儿死亡率。 7、减低妊娠反应。 【其他作用】 1、可以预防冠心病等慢性心血管病。 2、可预防老年痴呆和其他癌症，降低发生率。 3、减少和预防妇女乳腺癌和宫颈癌的发生几率。 4、预防和治疗药物引起的巨幼红细胞贫血。 【用法用量】不同的适应症，用法不同 1、用于预防出生缺陷和妊娠期、哺乳期妇女贫血和预防给药时;建议从结婚开始服用到哺乳期结束(孩子出生后六个月)，每日一片斯利安片(0.4mg)，曾有过神经管畸形儿生育史和怀疑有叶酸缺乏的妇女，每日两片斯利安片(0.8mg)。 2、每天服用量不宜超过1毫克。 3、斯利安片的其他适应范围服用时根据病情需要遵医嘱。 【不良反应】长期服用本品未见明显不良反应。 【禁忌症 】对本品过敏者禁用。 【注意事项】疑有叶酸盐依赖性肿瘤的育龄妇女慎服。 【药品规格】0.4mg*31片 【药品贮存】遮光，密闭保存 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 以下情况补叶酸要加大剂量 1.有过不良孕产史。如第一胎或第二胎流产、孩子生下不久夭折，或有其他不良妊娠结局。 中国是缺陷婴儿高发国家 全国人口和生育科学技术大会的最新数字表明:我国是世界上出生缺陷婴儿的高发国家之一。在每年3000万左右的新生儿中，约有4%,6%的缺陷儿出生。而在所有出生缺陷中，神经管畸形排名前三位。现有医学已经证明，导致神经管畸形的主要原因是体内缺乏叶酸。 “叶酸缺乏可导致胎儿大脑和中枢神经发育不良，新生儿可能是无脑儿或有脊柱裂的孩子。”陈新介绍说，脊柱裂的孩子幼年会有大小便失禁的毛病，长大后还可能下肢瘫痪。 神经管畸形发生率北方是南方10倍 “我们的研究表明，神经管畸形在我国长江以北发生率比较高，除了遗传因素之外，可能与人体内叶酸水平低有关。目前，北方新生儿神经管畸形的发生率是南方的10倍，具体原因不明。”陈新说。 陈新认为，对于想在婚后生育孩子的新人，结婚登记起就开始服用叶酸比较保险。因为新人们虽然无法准确预知哪一天会怀孕，但该所的研究表明，中国80,的夫妻都在结婚一年内怀孕。 叶酸在体内起效要两个月 现在有很多孕妇知道孕期补充叶酸对下一代健康有利。“但怀孕后才开始补充叶酸可能为时已晚。”陈新说，胚胎发育的第3,6周是人体各种器官形成的敏感时期，但女性通常在这个阶段还不知道自己已怀孕，一旦发现往往已超过一个月。 “由于叶酸要在人体内两个月左右才能达到人体需要的水平，因此，女性应在计划怀孕前3个月开始摄入足量叶酸，减少或避免神经管缺陷的发生。”但他也表示，如果发现意外怀孕，孕妇此时开始服用叶酸也比不服好。 (Kathy提醒:) 1(你老婆属于此类人群，要加大剂量～～ 2(你老婆怀上前补充叶酸了么,要两个月才见效 3(长期服用叶酸会干扰妈妈的锌代谢，锌一旦摄入不足，就会影响胎儿的发育。rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 妈妈最好能在医生的指导下服用叶酸制剂。目前市场上唯一得到国家卫生部门批准的、预防胎儿神经管畸形的叶酸增补剂是 " 斯利安 " 片，每片 400 微克。 3 、如果曾经生下过神经管缺陷婴儿的女性，再次怀孕时最好到医院检查，并 遵 医嘱增加每日的叶酸服用量，直至 孕 后 12 周。 4 、怀孕前长期服用避孕药、抗惊厥药等，可能干扰叶酸等维生素的代谢。计划怀孕的女性最好在孕前 6 个月停止用药，并补充叶酸等维生素。 神经管畸形会导致新生婴儿脊柱裂和无脑缺陷两种疾病。“先天性脊柱裂是骨质椎管发育畸形，阻碍脑血液循环，引起脑损害和脑积水。无脑是颅骨和大脑半球未能发育及神经管缺失畸形。”临床上，患有神经管畸形的婴儿大部分出生前、出生时或出生后一年内死亡。 叶酸水平过低可危害母子 在我国,神经管缺陷发病率呈“北高南低”、“农村多城市少”、“冬春季高于夏秋季”的特点。导致神经管畸形的主要原因是体内缺乏叶酸。 孕妇叶酸缺乏可能导致胎儿出生时出现低体重，唇腭裂，胎盘早期脱离，心脏缺陷，尤其以神经管缺陷最为常见。人类胚胎发育的前四周是中枢神经系统即脑和脊髓形成的关键时期。妊娠第二周，胚胎背侧形成神经板。第三到第四孕周，神经板变成神经管。妊娠第四周末，神经管应该闭合，管的头部发育增大形成脑，其余部分仍保持管状，形成脊髓。如果此时缺少叶酸导致营养不良或遭受到有害因素的影响，神经管的闭合不能如常进行，就会出现无脑儿和各种类型的脊柱裂等常见的神经管畸形。 通常认为，当妊娠期妇女的血清叶酸值小于6.8毫摩尔/升，或者红细胞叶酸值小于227微摩尔/升时，就是叶酸缺乏的信号。专家指出，叶酸水平过低还会给孕妇带来危险。这是因为细胞核在缺少叶酸的情况下成熟延缓，细胞核内RNA(核糖核酸)和DNA的比例随之失调，导致血红细胞体积庞大，但细胞核却很幼小，也就是所谓的“巨幼细胞”，孕妇因此出现贫血症状。严重时还会导致贫血性心脏病、妊娠期高血压病、胎盘早剥、早产和产褥感染等。 补充叶酸应在孕前三个月 新西兰奥塔格大学人类营养学高级讲师、加拿大盖儿福大学应用人类营养学博士蒂姆?格林(Tim Green)表示，经过宣传，大部分怀孕妇女已经知晓通过日常食物和孕妇奶粉等摄入叶酸。“但新的问题是3~4周，然而，通常妇女获知自己怀孕时，实际孕周已超过4周。因此，我们建议妇女在计划怀孕前的3个月，就开始摄入足量叶酸，这样可以减少或避免神经管缺陷的发生。” 也有观点认为补充叶酸不能过量，否则会造成多胎或者双胎，以及其他危害。“事实上，这只是医学界部分人士的猜测，尚未得到临床研究的证实。”格林博士指出，水溶族维生素都具有一种特性，如果在人体内水平过高，就会通过汗水和尿rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 液排到体外，毒性很低，不会像摄入过量维生素C那样对人体造成危害。“不过，从谨慎的角度出发，除非有病变，需要摄入规定剂量的叶酸予以治疗，否则，补充叶酸最好不要超过1000微克(1毫克=1000微克)的人体最高耐受量。” 食物经烹调叶酸损失大 受膳食结构影响，广东并不属于叶酸严重缺乏的区域，但近年来神经管畸形发病率并不低，排到了全省出生缺陷的前三位。“广东人还存在着一个认识上的误区，觉得通过食物补充叶酸就没多大问题了，实际上低估了叶酸在烹调中的损失。” 中山大学预防医学研究所副所长、中国营养学会妇幼分会委员蒋卓勤教授指出，要想从食品中获得足量的叶酸并不容易，一般要减去50%~90%的烹调损失。由于叶酸遇光、遇热就不稳定，容易失去活性，所以人体真正能从食物中获得的叶酸并没有想象中的多。 目前，营养学家建议育龄妇女每天摄入的叶酸不低于400微克，计划怀孕以及哺乳期的妇女每天叶酸摄入不低于600微克。食物方面，动物肝脏、肾脏、蛋类、鱼类、植物性食物中的绿叶蔬菜、菠菜、芹菜、菜花、土豆、莴苣、蚕豆、梨、柑橘、香蕉、柠檬、坚果类及大豆类等，都被认为是“天然叶酸大户”。 格林博士指出，除了食物，服用叶酸补充剂和叶酸强化食品如添加叶酸的谷类、奶粉等也是一种办法。一份美国的最新医疗研究显示，自从美国政府5年前批准含有强化叶酸的谷类食品在市场上出售后，患先天性脊柱裂和无脑的新生婴儿发病率下降了19%。 专家还建议，有不良妊娠史、高龄及家族中有生育过畸形胎儿史等高危因素的女性，最好在医生的指导下，在怀孕前三个月至妊娠早期每天口服叶酸片0.4毫克。还可每天补充300毫克的DHA，主要来源于金枪鱼、大马哈鱼等海洋鱼类，其中100克水煮大马哈鱼的含量为638毫克，一个鸡蛋的含量为19毫克，100克金枪鱼罐头的含量则为227毫克。 孕妇服用叶酸的问题 育龄妇女服用叶酸增补可以预防胎儿神经管畸形.我国目前约有30%的育龄妇女体内叶酸缺乏，而孕妇由于对叶酸的需求量更多，因此叶酸不足的情况也就更严重。 孕妇每日需要叶酸0.4毫克，而一般从膳食中摄取的叶酸只有0.05mg.具体的服用时间应从计划怀孕前.至少1个月开始服用，每日服用O.4毫克的叶酸增补剂，一直持续服用怀孕后3个月末为止. 强调怀孕前就要开始服用的目的是为使妇女体内的叶酸维持在一定的水平，以保证胚胎早期有一个较好的叶酸营养状态。(妇女在服用叶酸后要经过4周的时间，体内叶酸缺乏的状态才能得以纠正) 服用叶酸增补剂，不仅可以预防胎儿神经管畸形的发生，而且对于自然流产，胎儿宫内发育迟缓和孕妇贫血等症有着特异性疗效。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities 不要用“叶酸片”代替“小剂量叶酸增补剂”。叶酸增补剂每片中仅含0.4毫克叶酸，是国家批准的惟一预防药品(商品名称为“斯利安”)。而市场上有一种供治疗贫血用的“叶酸片”，每片含叶酸5毫克，相当于“斯利安”片的12.5倍。孕妇在孕早期切忌服用这种大剂量的叶酸片，因为长期大剂量服用叶酸片对孕妇和胎儿会产生不良的影响 还有就是有专家认为食用过多的叶酸强化食品会导致下一代更容易受到致命疾病的侵害，因为叶酸强化食品可能改变人类的基因组成。他们建议应该考虑降低推荐食品中的叶酸含量，应从每日的0.4毫克降低到0.2毫克。 rAt present, we have formed a "three-three" Park. …… Industrial Park, according to ... ... The instructions of comrade, focus on development needs in the next decade, based on the original, and then extended the 6 square kilometers. Of the Park, to further improve the roads, power supply, communications, water supply and drainage and sewage pipe network and other infrastructure, to achieve full coverage of infrastructure and interconnection with the facilities and raise capacity. Each park to determine 1 leading industries, in particular stone Materials, cans, gloves, through guided, force and other measures to promote the "road company" Park, industrial agglomeration. Currently, to focus on building better ... ... Industrial Park, ... ... Wood Park as the starting area of the industrial park, planners need to take out plan, start construction as soon as possible, undertake in a timely manner ... ... Transfer of the wood industry. This opportunity slip by, so the timing must be tight. Second is to optimize government service. Low efficiency of government services, departments do not coordinate the views of businesses large, poor business environment, it is ... ... Short Board, decide to change. We will continue to deepen reform of the administrative examination and approval system, good digestion, implement the Government canceled, adjustment and devolution of administrative examination and approval matters, strengthen the existing supervision in matters of administrative power, has made it clear to cancel, are not allowed to keep or disguised approval. To do list list of administrative powers and responsibilities