母体血清微RNA-146a-5p联合三联法检测在孕中期唐氏综合征筛查中的意义  

Significance of maternal serum miR-146a-5p combined with triple assay in screening for Down's syndrome in the midtrimester

作　　者：肖欢 张志安[1] 梅军华 张仙 XIAO Huan;ZHANG Zhian;MEI Junhua;ZHANG Xian(Obstetrics and Gynecology of Huanggang Central Hospital,Huanggang,Hubei 438000,China;Obstetrics and Gynecology of Hubei Maternal and Child Health Hospital,Wuhan,Hubei 430000,China)

机构地区：[1]黄冈市中心医院妇产科,湖北黄冈438000 [2]湖北省妇幼保健院妇产科,湖北武汉430000

出　　处：《安徽医药》2023年第6期1231-1234,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 探讨母体血清微RNA-146a-5p(miR-146a-5p)联合三联法检测在孕中期唐氏综合征筛查中的意义。方法 选取2017年1月至2020年8月于黄冈市中心医院孕中期行唐氏综合征筛查结果为阳性的孕妇65例(病例组),同期选择本院健康的妊娠孕妇65例(对照组)。使用化学发光免疫分析仪检测孕妇血清甲胎蛋白(AFP),人绒毛膜促性腺激素(β-hCG)以及游离雌三醇(uE3)指标。实时荧光定量PCR法检测血清中miR-146a-5p的水平。采用受试者操作特征(ROC)曲线分析母体血清miR-146a-5p联合三联法对孕中期唐氏综合征的预测价值。采用Pearson法分析miR-146a-5p相对表达水平与血清AFP、uE3、β-hCG中位数的倍数(MOM)值的相关性。结果 与对照组(1.89±0.32)U/mL、(1.63±0.36)μg/L、1.03±0.24、(2.41±0.28)μg/L相比,病例组孕妇血清AFP MOM值(2.84±0.27)U/mL、β-hCG MOM值(2.84±0.25)μg/L及血清miR-146a-5p相对表达水平3.07±0.95较高(P<0.05),uE3 MOM值(1.71±0.19)μg/L较低(P<0.05)。Pearson法分析显示,miR-146a-5p与AFP、β-hCG呈正相关(P<0.05),与uE3呈负相关(P<0.05)。ROC曲线结果显示,AFP+uE3+β-hCG预测孕中期唐氏综合征的曲线下面积(AUC)为0.85,灵敏度分别为83.10%,特异度分别为75.40%;miR-146a-5p预测孕中期唐氏综合征的AUC为0.86,灵敏度为81.50%,特异度为87.70%;miR-146a-5p+AFP+uE3+β-hCG预测子孕中期唐氏综合征的AUC为0.91,灵敏度为86.20%,特异度为80.00%,miR-146a-5p联合三联法检测对孕中期唐氏综合征筛查价值高于三联法检测(P<0.05)。结论 母体血清miR-146a-5p联合三联法对孕中期唐氏综合征的预测效能具有较高的临床价值,可为孕中期唐氏综合征筛查提供一种新途径。Objective To explore the significance of maternal serum microRNA-146a-5p(miR-146a-5p)combined with a triple assay in screening for Down's syndrome in the midtrimester.Methods A total of 65 pregnant women who had positive results of Down's syndrome screening performed in the midtrimester at Huanggang Central Hospital from January 2017 to August 2020 were selected(case group),and 65 healthy pregnant women from the hospital during the same period were selected(control group).A chemiluminescence immunoassay analyzer was used to detect serum alpha-fetoprotein(AFP),β-human chorionic gonadotropin(β-hCG)and free estriol(uE3)indicators in pregnant women.A real-time fluorescent quantitative PCR assay was performed to detect the serum miR-146a-5p levels.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of maternal serum miR-146a-5p combined with the triple assay for Down's syndrome in the midtrimester.The Pearson method was used to analyze the correlation between the relative expression levels of miR-146a-5p and the serum AFP,uE3,andβ-hCG multiple of the median(MOM)values.Re⁃sults Compared with the control group(1.89±0.32)U/mL,(1.63±0.36)μg/L,1.03±0.24 and(2.41±0.28)μg/L,the serum AFP MOM(2.84±0.27)U/mL,β-hCG MOM values(2.84±0.25)μg/L and the relative serum miR-146a-5p level 3.07±0.95 were higher in pregnant women in the case group(P<0.05),and the uE3 MOM value(1.71±0.19)μg/L was lower(P<0.05).Pearson analysis showed that miR-146a-5p was positively correlated with AFP andβ-hCG(P<0.05)and negatively correlated with uE3(P<0.05).The ROC curve results showed that the area under the curve(AUC)of AFP+uE3+β-hCG for predicting Down's syndrome in the midtrimester was 0.85,with a sensitivity of 83.10%and a specificity of 75.40%;the AUC of miR-146a-5p for predicting Down's syndrome in the midtrimester was 0.86,with a sensitivity of 81.50%and a specificity of 87.70%.The AUC of miR-146a-5p+AFP+uE3+β-hCG for predicting Down's syndrome in midtrimester was 0.91,with a sensitivity

关 键 词：唐氏综合征 微RNA-146a-5p 新生儿筛查 妊娠中期 甲胎蛋白类 绒毛膜促性腺激素 β亚单位 人 雌三醇 

分 类 号：R714.5[医药卫生—妇产科学]