孕妇血清CG、TBA、miR-222与妊娠中晚期ICP病情程度的关系及联合预测AFO的ROC分析  

Relationship between Serum CG,TBA,miR-222 and Severity of ICP in Mid and Late Pregnancy and ROC Analysis of Combined Prediction of Fetal Adverse Outcomes

作　　者：章茜[1] 褚艳侠[1] ZHANG Qian;CHU Yanxia(Suzhou Municipal Hospital,Suzhou City,Jiangsu Province 215000)

机构地区：[1]苏州市立医院本部产科,江苏省苏州市215000

出　　处：《医学理论与实践》2023年第24期4163-4165,4172,共4页The Journal of Medical Theory and Practice

基　　金：东南大学附属中大医院重症医学邱海波临床专家团队(SZYJTD201709)。

摘　　要：目的:探讨孕妇血清CG、TBA、miR-222与妊娠中晚期妊娠期胆汁淤积症(ICP)病情程度的关系及联合预测胎儿不良结局的ROC价值。方法:选择2018年1月—2020年12月在我院就诊的ICP患者73例作为ICP组,按1∶1抽取同期在我院就诊的健康孕妇73例作为对照组。观察2组孕妇血清CG、TBA、miR-222水平,观察CG、TBA、miR-222对胎儿不良结局事件(AFO)的预测价值。结果:ICP组血清CG、TBA、miR-222水平均高于对照组,差异均有统计学意义(P<0.05);亚组分析显示,SICP组CG、TBA和miR-222水平均高于MICP组,差异均有统计学意义(P<0.05)。ICP组AFO发生率显著高于对照组,差异有统计学意义(P<0.05)。AFO组患者血清CG、TBA、miR-222水平均高于非AFO组,差异均有统计学意义(P<0.05)。CG、TBA、miR-222预测AFO的灵敏度分别为84.2%、84.2%和78.9%,特异性分别为87.0%、81.5%和94.4%;CG、TBA、miR-222之一阳性预测AFO的灵敏度为94.7%,高于CG、TBA、miR-222单独检测的灵敏度;CG、TBA、miR-222均阳性预测AFO的特异性为98.1%,高于CG、TBA、miR-222单独检测的特异性。结论:血清CG、TBA和miR-222与ICP严重程度相关,miR-222预测AFO的临床价值优于CG和TBA,CG、TBA和miR-222不同联合方式有助于AFO的确诊和排除,值得临床推广应用。Objective:To explore the relationship between serum CG,TBA,miR-222 and the severity of ICP in the second and third trimester of pregnancy,and the value of ROC in predicting adverse fetal outcomes.Methods:73 patients with ICP in our hospital from January 2018 to December 2020 were selected as ICP group,and 73 healthy pregnant women in our hospital at the same period were selected as control group according to 1∶1 ratio.The serum levels of CG,TBA and miR-222 were observed,and the predictive value of CG,TBA and miR-222 in predicting fetal adverse outcome(AFO)was observed.Results:The levels of serum CG,TBA and miR-222 in ICP group were significantly higher than those in control group(P<0.05).Subgroup analysis showed that the levels of CG,TBA and miR-222 in SICP group were higher than those in MICP group(P<0.05).The incidence of AFO in ICP group was significantly higher than that in control group(P<0.05).The serum levels of CG,TBA and miR-222 in the AFO group were higher than those in the non AFO group(P<0.05).The sensitivity of CG,TBA and miR-222 in predicting AFO was 84.2%,84.2%and 78.9%,respectively,and the specificity was 87.0%,81.5%and 94.4%,respectively.The sensitivity of CG,TBA and miR-222 in predicting AFO was 94.7%,which was higher than that of CG,TBA and miR-222 alone.The specificity of CG,TBA and miR-222 in predicting AFO was 98.1%,which was higher than that of CG,TBA and miR-222 alone.Conclusion:Serum CG,TBA and miR-222 are related to the severity of ICP.The clinical value of miR-222 in predicting AFO is better than CG and TBA.Different combination of CG,TBA and miR-222 is helpful to the diagnosis and exclusion of AFO,which is worthy of clinical application.

关 键 词：妊娠期肝内胆汁淤积 总胆汁酸 甘胆酸 微小RNA MIR-222 

分 类 号：R714[医药卫生—妇产科学]