孕早期彩色多普勒超声联合血清miR-339-5p和SIRT3检测对胎儿心脏畸形和染色体异常的诊断价值研究  

Value of Color Doppler Ultrasound Combined with Serum miR⁃339⁃5p and SIRT3 in the Diagnosis of Fetal Cardiac Abnormalities and Chromosomal Abnormalities in Early Pregnancy

作　　者：邓素梅[1] 杜学文[1] 邹丹 DENG Sumei;DU Xuewen;ZOU Dan(Department of Ultrasound,Mianyang Maternal and Child Health Hospital,Mianyang 621000,Sichuan,China;Laboratory Department,Mianyang Maternal and Child Health Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]绵阳市妇幼保健院超声科,四川绵阳621000 [2]绵阳市妇幼保健院检验科,四川绵阳621000

出　　处：《中国分子心脏病学杂志》2024年第6期6510-6515,共6页Molecular Cardiology of China

摘　　要：目的探讨孕早期彩色多普勒超声参数联合血清微小RNA-339-5p(miR-339-5p)、沉默信息调节因子3(SIRT3)对胎儿心脏畸形及染色体异常的诊断价值。方法选取绵阳市妇幼保健院2019年4月—2023年1月期间收治的64例诊断为胎儿心脏畸形的孕早期孕妇作为心脏畸形组,62例诊断为胎儿染色体异常的孕早期孕妇作为染色体异常组,另选取72例胎儿正常的孕早期孕妇作为对照组。采用彩色多普勒超声诊断仪检测胎儿静脉导管超声参数:心房收缩期峰值速度(A)、心室舒张期峰值速度(D)、心室收缩期速度(S)、a波最大速度(TA_(max))及搏动指数(PI)。采用酶联免疫吸附法(ELISA)检测血清SIRT3水平,采用实时荧光定量PCR(qRT-PCR)法检测血清miR-339-5p水平;采用Pearson相关分析检验心脏畸形胎儿及染色体异常胎儿血清miR-339-5p、SIRT3水平与超声血流参数的相关性;绘制受试者工作特征(ROC)曲线评估超声血流参数和miR-339-5p、SIRT3水平对胎儿心脏畸形及染色体异常的诊断价值。结果心脏畸形组、染色体异常组PI、miR-339-5p高于对照组,A、D、S、TA_(max)、SIRT3低于对照组,差异均有统计学意义(P<0.05)。心脏畸形胎儿、染色体异常胎儿血清miR-339-5p与A、D、S、TA_(max)呈负相关,与PI呈正相关(P<0.05);SIRT3与A、D、S、TA_(max)呈正相关,与PI呈负相关(P<0.05)。A、D、S、TA_(max)、PI、miR-339-5p、SIRT3单独及联合诊断胎儿心脏畸形的曲线下面积(AUC)分别为0.717、0.702、0.780、0.788、0.752、0.752、0.801、0.978,诊断胎儿染色体异常的AUC分别为0.763、0.724、0.738、0.835、0.822、0.857、0.795、0.989。结论孕早期彩色多普勒超声参数联合血清miR-339-5p、SIRT3检测可有效提高胎儿心脏畸形及染色体异常的产前诊断率。Objective To explore the diagnostic value of color Doppler ultrasound parameters combined with serum microRNA⁃339⁃5p(miR⁃339⁃5p)and silent information regulator 3(SIRT3)in the diagnosis of fetal cardiac abnormalities and chromosomal abnormalities in early pregnancy.Methods From April 2019 to January 2023,64 early pregnant women diagnosed with fetal heart malformation admitted to Mianyang Maternal and Child Health Hospital were regarded as the heart malformation group,and 62 early pregnant women diagnosed with fetal chromosome abnormality were regarded as the chromosome abnormality group,another 72 pregnant women with normal fetuses were regarded as the control group.Color Doppler ultrasound diagnostic instrument was applied to detect the ultrasound parameters:atrial systolic peak velocity(A),ventricular diastolic peak velocity(D),ventricular systolic velocity(S),a⁃wave maximum velocity(TA_(max)),pulsation index(PI),the serum SIRT3 level was detected by enzyme⁃linked immunosorbent assay(ELISA),the serum miR⁃339⁃5p level was detected by real⁃time fluorescence quantitative PCR(qRT⁃PCR);Pearson correlation analysis was applied to examine the correlation between the serum miR⁃339⁃5p,SIRT3 levels and ultrasound blood flow parameters in the fetus with cardiac abnormalities and chromosomal abnormalities;receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of ultrasound blood flow parameters,miR⁃339⁃5p and SIRT3 levels for fetal cardiac abnormalities and chromosomal abnormalities.Results PI and miR⁃339⁃5p in the cardiac malformation group and chromosome abnormality group were higher than those in the control group,and A,D,S,TA_(max)and SIRT3 were lower than those in the control group(P<0.05).The serum miR⁃339⁃5p was negatively correlated with A,D,S,TA_(max),and positively correlated with PI(P<0.05);SIRT3 was positively correlated with A,D,S and TA_(max),and negatively correlated with PI(P<0.05).The area under the curve(AUC)of A,D,S,TA_(max),PI,miR⁃339

关 键 词：胎儿 心脏畸形 染色体异常 彩色多普勒超声 微小RNA-339-5p 沉默信息调节因子3 

分 类 号：R714.5[医药卫生—妇产科学]