摘要
目的 分析子痫前期(preeclampsia,PE)孕妇血清微小核糖核酸-411-5p(miR-411-5p)和微小核糖核酸-485-5p(miR-485-5p)水平检测联合超声血流指标对围生儿结局的预测价值研究.方法 选择2020年1月～2021年12月在北京核工业医院产科建卡并行剖宫产术的88例PE孕妇为研究对象(PE组),另选取同期因其它各种原因剖宫产分娩的正常孕妇90例作为对照组,比较两组间超声血流指标搏动指数(pulsitility index,PI)、阻力指数(resistance index,RI)差异,实时荧光定量 PCR(real time fluorescent quantitative PCR,qRT-PCR)法检测两组间血清 miR-411-5p 和 miR-485-5p水平并比较,根据PE患者围生儿结局的不同分为结局良好组与结局不良组,比较组间PI,RI,miR-411-5p和miR-485-5p 的差异,采用受试者工作特征(receiver operating characteristic,ROC)曲线法分析 PI,RI,miR-411-5p,miR-485-5p以及联合检测对PE患者围生儿不良结局的预测作用.结果 PE组孕妇RI(0.79±0.08),PI值(1.82±0.08)高于对照组(0.66±0.06,1.38±0.15),血清 miR-411-5p(0.32±0.09),miR-485-5p(0.26±0.03)水平低于对照组(1.01±0.08,1.02±0.09),差异具有统计学意义(t=12.283,24.339,54.091,75.231,均 P＜0.001);结局不良组 PE 患者 RI(0.83±0.08),PI(1.86±0.09)值高于结局良好组(0.70±0.07,1.71±0.07),血清 miR-411-5p(0.27±0.02),miR-485-5p(0.24±0.02)水平低于结局良好组(0.45±0.04,0.31±0.04),差异具有统计学意义(t=11.545,12.428,37.840,14.716,均P＜0.001).超声血流指标RI,PI预测PE患者围生儿不良结局的曲线下面积为0.838(敏感度为90.8％,特异度为65.2％)、0.758(敏感度为50.8％,特异度为91.3％);血清miR-411-5p,miR-485-5p预测PE患者围生儿不良结局的曲线下面积为0.830(敏感度为90.8％,特异度为73.9％)、0.769(敏感度为95.4％,特异度为61.9％),四者联合检测预测PE患者围生儿不良结局的曲线下面积为0.976(敏感度为98.5％,特异度为91.3％).结论 PE孕妇血清miR-411-5p和miR-485-5p水平降低,血清miR-411-5p和miR-485-5p水平联合超声血流指标PI,RI对PE孕妇围生期胎儿结局具有预测作用.
Abstract
Objective To analyze the predictive value of serum micro RNA(miR)-411-5p and micro RNA(miR)-485-5p levels in preeclampsia(PE)pregnant women combined with ultrasound blood flow indicators for perinatal outcomes.Methods A total of 88 pregnant women with PE who were enrolled in the obstetric card and underwent cesarean section in Beijing Nuclear Industry Hospital from January 2020 to December 2021 were selected as the study subjects(PE group).In addition,90 normal pregnant women who delivered by cesarean section due to other reasons in the same period were regarded as the control group.The differences of pulsitility index(PI)and resistance index(RI)were compared between the two groups.The serum levels of miR-411-5p and miR-485-5p were measured and compared between the two groups by real time fluorescent quantitative PCR(qRT-PCR).According to the different perinatal outcomes of PE patients,they were grouped into good outcome group and poor outcome group.The differences of PI,RI,miR-411-5p and miR-485-5p between the two groups were compared.The predictive effect of PI,RI,miR-411-5p,miR-485-5p and combined detection on the adverse perinatal outcome of PE patients was analyzed by the receiver operating characteristic(ROC)curve method.Results The RI(0.79±0.08)and PI values(1.82±0.08)of pregnant women in the PE group were higher than those in the control group(0.66±0.06,1.38±0.15),the serum levels of miR-411-5p(0.32±0.09)and miR-485-5p(0.26±0.03)were lower than those in the control group(1.01±0.08,1.02±0.09),and the differences were statistically significant(t=12.283,24.339,54.091,75.231,all P＜0.001).The RI(0.83±0.08)and PI(1.86±0.09)values of PE patients in the poor outcome group were higher than those in the good outcome group(0.70±0.07,1.71±0.07),the serum levels of miR-411-5p(0.27±0.02)and miR-485-5p(0.24±0.02)were lower than those in the good outcome group(0.45±0.04,0.31±0.04),and the differences were statistically significant(t=11.545,12.428,37.840,14.716,all P＜0.001).The areas under the curve of ultrasound blood flow index RI and PI to predict the adverse perinatal outcome of PE patients were 0.838(sensitivity was 90.8％,specificity was 65.2％),and 0.758(sensitivity was 50.8％,specificity was 91.3％),respectively.The areas under the curve of serum miR-411-5p and miR-485-5p in predicting adverse perinatal outcome of PE patients were 0.830(sensitivity was 90.8％,specificity was 73.9％),and 0.769(sensitivity was 95.4％,specificity was 61.9％),respectively.The area under the curve of the four combined tests to predict the adverse perinatal outcome of PE patients was 0.976(sensitivity was 98.5％,specificity was 91.3％).Conclusion The levels of miR-411-5p and miR-485-5p in serum of PE pregnant women were decreased,and the combination of miR-411-5p and miR-485-5p and ultrasound blood flow indicators PI and RI may predict the perinatal fetal outcome of PE pregnant women.
国家科技期刊平台
NSTL
万方数据