外周血miR-152、PIGF、sFlt-1和sEng水平对子痫前期患者不良孕产结局的预测分析  

Prediction of adverse pregnancy outcomes in preeclampsia patients using peripheral blood miR-152,PIGF,sFLT-1 and sEng levels

作　　者：宋姗姗[1] 杨洋[1] 陈阳[1] 何静[1] SONG Shanshan;YANG Yang;CHEN Yang;HE Jing(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Xi′an Medical College,Shaanxi Xi'an 710077,China)

机构地区：[1]西安医学院第一附属医院妇产科,陕西西安710077

出　　处：《中国妇幼健康研究》2022年第2期45-49,共5页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金项目(81901510);陕西省自然科学基础研究计划(2020JM-615);西安市科技计划项目[20YXYJ0005(6)]。

摘　　要：目的探讨子痫前期(PE)患者血清中微小RNA152(miR-152)、胎盘生长因子(PIGF)、可溶性血管内皮生长因子(sFlt-1)及可溶性内皮抑素(sEng)表达水平对不良孕产结局的诊断预测价值。方法选取西安医学院第一附属医院2019年1月至2020年12月收治的145例PE患者为研究对象,其中发生不良孕产结局者为研究组(n=60),未发生不良孕产结局者为对照组(n=85),绘制受试者工作特征(ROC)曲线、计算曲线下面积(AUC)分析预测价值。结果本研究145例PE患者中发生不良孕产结局的患者为60例(41.38%),其中早产40例(66.67%)、胎盘早剥5例(8.33%)、胎儿窘迫12例(20.00%)、低出生体重儿44例(73.33%)、胎死宫内1例(1.67%)、新生儿肺炎13例(21.67%);研究组患者孕周和胎儿出生体重小于对照组,差异有统计学意义(t/H值分别为7.58、11.29,P<0.05),两组间年龄和住院天数差异无统计学意义(P>0.05);与对照组相比,研究组患者miR-152、sFlt-1、sEng的表达水平上升,PIGF水平下降,差异均具有统计学意义(t/H值分别为-7.73、-3.62、-5.18、4.06,P<0.05);单独指标诊断PE患者发生不良孕产结局时,miR-152诊断AUC最大,为0.80;联合指标诊断时,AUC为0.89,特异性为86.23%,敏感性为77.47%。结论PE患者血清中PIGF、sFlt-1和sEng水平联合miR-152检测,对于PE患者发生不良孕产结局的预测诊断具有一定临床价值。Objective To investigate the diagnostic and predictive value of serum microRNA-152(miR-152),placental growth factor(PIGF),soluble fms-like tyrosine kinase 1(sFlt-1),and soluble endoglin(sEng)of patients with preeclampsia(PE)on adverse pregnancy outcomes.Methods A total of 145 PE patients admitted to the First Affiliated Hospital of Xi′an Medical College from January 2019 to December 2020 were selected as the research objects.Those with adverse pregnancy outcomes were selected as the research group(n=60),and those without adverse pregnancy outcomes were selected as the control group(n=85).Receiver operating characteristic(ROC)curves were drawn and the area under the curve(AUC)was calculated to analyze the predictive value.Results Among the 145 PE patients,60 cases(41.38%)had adverse pregnancy outcomes,including 40(66.67%)cases of premature birth,5(8.33%)cases of placental abruption,12(20.00%)cases of fetal distress,and 44(73.33%)cases of low birth weight,1(1.67%)case of intrauterine stillbirth,and 13(21.67%)cases of neonatal pneumonia.The gestational age and birth weight in the research group were lower than those in the control group,and the differences were statistically significant(t/H=7.58 and 11.29,respectively,P<0.05),there was no significant difference in age and length of hospitalization between the two groups(P>0.05).Compared with the control group,the expression levels of miR-152,sFlt-1 and sEng in the research group increased,and the expression level of PIGF in the research group decreased,and the differences were statistically significant(t/H=-7.73,-3.62,-5.18 and 4.06,respectively,P<0.05).ROC curve analysis suggested that miR-152 alone had a better diagnostic predictive value on adverse pregnancy outcomes in patients with PE,with an AUC area of 80%.Combining the above indicators,the AUC area was 89%,the specificity was 86.23%,and the sensitivity was 77.47%.Conclusion The serum levels of PIGF,sFlt-1 and sEng levels in PE patients combined with the detection of miR-152 have certain clinical value for

关 键 词：子痫前期 血清微小RNA 胎盘生长因子 可溶性血管内皮生长因子 可溶性内皮抑素 

分 类 号：R714.245[医药卫生—妇产科学]