妊娠期高血压疾病患者血清ELA、MALAT1变化与病情程度及妊娠结局的关系  

Serum ELA,MALAT1 levels in patients with gestational hypertension and their relationship with disease severity and pregnancy outcomes

作　　者：段娟 陈雪蓉 沈冉 李瑞华 孟海云 Duan Juan;Chen Xuerong;Shen Ran;Li Ruihua;Meng Haiyun(Department of Obstetrics,Yan'an Hospital,Yunnan,Kunming 650001,China)

机构地区：[1]云南省昆明市延安医院产科,650001

出　　处：《疑难病杂志》2025年第3期328-332,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：云南省科技厅科技计划项目(202401AY070001-193)。

摘　　要：目的探讨妊娠期高血压疾病(HDCP)患者血清ELABELA(ELA)、长链非编码RNA肺腺癌转移相关转录子1(MALAT1)的表达与病情程度及妊娠结局的关系。方法选取2021年2月-2023年2月云南省昆明市延安医院产科诊治的HDCP患者102例为HDCP组。根据不同病情程度将患者分为妊娠期高血压亚组34例、轻度子痫前期(PE)亚组35例、重度PE亚组33例;根据不同妊娠结局将患者分为预后良好亚组66例和预后不良亚组36例。另选取同期医院体检的健康孕妇60例为健康对照组。采用酶联免疫吸附试验和qPCR检测血清ELA、MALAT1水平;多因素Logistic回归分析HDCP患者不良妊娠结局预后的影响因素;受试者工作特征(ROC)曲线评价血清ELA、MALAT1水平对HDCP患者不良妊娠结局预后的预测价值。结果HDCP组血清ELA、MALAT1水平低于健康对照组(t/P=17.101/<0.001、15.035/<0.001);血清ELA、MALAT1水平比较:妊娠期高血压亚组>轻度PE亚组>重度PE亚组(F/P=115.480/<0.001、40.421/<0.001);预后不良亚组HDCP患者收缩压高于预后良好亚组,而血清MALAT1、ELA水平低于预后良好亚组(t/P=7.347/<0.001、8.898/<0.001、11.100/<0.001);收缩压升高是HDCP患者不良妊娠结局预后的独立危险因素[OR(95%CI)=1.556(1.230~1.968)],血清MALAT1、ELA水平升高是独立保护因素[OR(95%CI)=0.680(0.548~0.843)、0.754(0.617~0.920)];血清ELA、MALAT1水平及二者联合预测HDCP患者不良妊娠结局预后的曲线下面积(AUC)分别为0.838、0.829、0.912,二者联合的AUC大于血清ELA、MALAT1水平单独预测(Z/P=4.613/<0.001、4.820/<0.001)。结论HDCP患者血清ELA、MALAT1降低,与病情严重程度有关,二者联合对HDCP不良妊娠结局具有较高的预测价值。Objective To investigate the expression of serum ELABELA(ELA),long non coding RNA lung adenocarcinoma transcript 1(MALAT1)in patients with gestational hypertension(HDCP),and their relationship with the severity of the disease and pregnancy outcomes.Methods One hundred and two patients with HDCP treated in our hospital from February 2021 to February 2023 were selected and divided into three subgroups based on the severity of their condition:gestational hypertension subgroup(34 cases),mild preeclampsia subgroup(35 cases),and severe preeclampsia subgroup(33 cases);Based on pregnancy outcomes,they were grouped by a good prognosis subgroup(66 cases)and a poor prognosis subgroup(36 cases),with 60 healthy pregnant women in the same period as the control group.Enzyme linked immunosorbent assay and qPCR were conducted to detect serum ELA and MALAT1 levels,respectively.The evaluation value of serum ELA and MALAT1 for adverse pregnancy outcomes in HDCP were analyzed by logistic regression model and receiver operating characteristic curve.Results The serum ELA and MALAT1 levels in the HDCP group were lower than those in the control group(t/P=17.101/<0.001,15.035/<0.001).The serum ELA and MALAT1 levels in the gestational hypertension subgroup,mild PE subgroup,and severe PE subgroup decreased sequentially(F/P=115.480/<0.001,40.421/<0.001).Compared with the good prognosis subgroup,the poor prognosis subgroup of HDCP patients had higher systolic blood pressure,lower serum MALAT1,and ELA(t/P=7.347/<0.001,8.898/<0.001,11.100/<0.001).Systolic blood pressure is a risk factor for adverse pregnancy outcomes in HDCP patients[OR(95%CI)=1.556(1.230-1.968)],while serum MALAT1 and ELA were protective factors[OR(95%CI)=0.680(0.548-0.843),0.754(0.617-0.920)].The area under the curve(95%CI)of the combined use of serum ELA and MALAT1 for prognostic evaluation of adverse pregnancy outcomes in HDCP was 0.912(0.881-0.940),which was superior to serum ELA and MALAT1 alone at 0.838(0.790-0.869)and 0.829(0.783-0.856)(Z/P=4.613/<0.001,4.820/<0.001).Co

关 键 词：妊娠期高血压 ELABELA 长链非编码RNA肺腺癌转移相关转录子1 妊娠结局 

分 类 号：R714.246[医药卫生—妇产科学]