早发型子痫前期患者外周血miR-191-5p水平对不良妊娠结局的预测价值分析  

Predictive value of miR-191-5p level in peripheral blood of patients with early-onset preeclampsia on adverse pregnancy outcome

作　　者：赵静[1,2] 徐琳 ZHAO Jing;XU Lin(Medical College,Qingdao University,Qingdao 266021,Shandong,China;Department of Obstetrics,Qingzhou Maternal and Child Health Care Hospital,Weifang 262500,Shandong,China;Department of Obstetrics,Affiliated Hospital of Medical College of Qingdao University,Qingdao 266003,Shandong,China)

机构地区：[1]青岛大学医学院,山东青岛266021 [2]青州市妇幼保健院产科,山东潍坊262500 [3]青岛大学医学院附属医院产科,山东青岛266003

出　　处：《中国性科学》2021年第7期40-44,共5页Chinese Journal of Human Sexuality

基　　金：国家自然科学基金面上项目(81571408)。

摘　　要：目的探讨早发型子痫前期患者外周血miR-191-5p水平对不良妊娠结局的预测价值。方法选取2018年1月至2020年1月在青岛大学医学院附属医院住院分娩的178例早发型子痫前期患者作为研究对象。根据妊娠结局将其分为母体不良结局组(n=54)、非母体不良结局组(n=124),以及围产儿不良结局组(n=27)、非围产儿不良结局组(n=151),对比其孕28周时外周血miR-191-5p水平的差异,采用受试者操作特征(ROC)曲线分析外周血miR-191-5p水平对不良妊娠结局的预测价值。采用单因素、多因素回归模型分析早发型子痫前期患者不良妊娠结局发生的危险因素。结果孕28周时,母体不良结局组外周血miR-191-5p的表达水平高于非母体不良结局组,围产儿不良结局组外周血miR-191-5p的表达水平高于非围产儿不良结局组,差异具有统计学意义(P<0.05)。ROC曲线显示,孕28周时外周血miR-191-5p水平预测早发型子痫前期患者母体不良结局的临界值为>0.67,AUC为0.831(95%CI0.770~0.893),对应的灵敏度、特异度分别为66.94%、77.78%;预测围产儿不良结局的临界值为>0.71,AUC为0.871(95%CI0.800~0.941),对应的灵敏度、特异度分别为80.13%、74.07%。Logistics回归分析发现,首次产检收缩压(SBP)≥160mmHg、24h蛋白尿定量≥2.0g/24h、血小板<100×10^(9)、D-二聚体≥0.5、外周血miR-191-5p水平>0.67是早发型子痫前期患者母体不良结局发生的独立危险因素(P<0.05);首次产检SBP≥160mmHg、24h蛋白尿定量≥2.0g/24h、血小板<100×10^(9)、D-二聚体≥0.5、外周血miR-191-5p水平>0.71是早发型子痫前期患者围产儿不良结局发生的独立危险因素(P<0.05)。结论外周血miR-191-5p水平异常增高是早发型子痫前期患者不良妊娠结局发生的独立危险因素,且具有一定预测价值。Objective To explore the predictive value of miR-191-5 p level in peripheral blood of patients with early-onset preeclampsia on adverse pregnancy outcome. Methods 178 patients with early onset preeclampsia who delivered in the Affiliated Hospital of Medical College of Qingdao University from January 2018 to January 2020 were selected, and divided into maternal adverse outcome group(n=54), non-maternal adverse outcome group(n=124), perinatal adverse outcome group(n=27) and non-perinatal adverse outcome group(n=151) according to the pregnancy outcome. The differences in the level of miR-191-5 p in their peripheral blood at 28 weeks of gestation were compared. The predictive value of miR-191-5 p level in peripheral blood for adverse pregnancy outcomes was analyzed using receiver operating characteristic(ROC) curve. Univariate and multivariate regression models were used to analyze the risk factors for adverse pregnancy outcomes in patients with early onset preeclampsia. Results At 28 weeks of gestation, the expression level of miR-191-5 p in peripheral blood of the maternal adverse outcome group was higher than that of the non-maternal adverse outcome group, and the expression level of miR-191-5 p in peripheral blood of the perinatal adverse outcome group was higher than that of the non-perinatal adverse outcome group, with statistical significance(P<0.05). ROC curve showed that the cut-off value of miR-191-5 p level in peripheral blood at 28 weeks of gestation for predicting maternal adverse outcomes in patients with early-onset preeclampsia was >0.67, and the AUC was 0.831(95%CI 0.770~0.893), with corresponding sensitivity and specificity of 66.94% and 77.78%, respectively. The cut-off value for predicting perinatal adverse outcomes was >0.71 and AUC was 0.871(95%CI 0.800~0.941). The corresponding sensitivity and specificity were 80.13% and 74.07%, respectively. Logistics regression analysis found that SBP≥160 mmHg, 24 h proteinuria≥2.0 g/24 h, platelet <100×10^(9), D-dimer≥0.5, and >0.67 of miR-191-5 p lev

关 键 词：早发型子痫前期 miR-191-5p 不良妊娠结局 预测价值 

分 类 号：R714[医药卫生—妇产科学]