孕妇外周血miR-152 miR-210与子痫前期病情程度及妊娠结局的相关性研究

doi:10.3969/j.issn.1006-6233.2024.05.027

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摘要 目的: 探究孕妇外周血微小RNA-152(miR-152)、miR-210与子痫前期(PE)病情程度及妊娠结局的相关性。方法: 选取2018年7月至2022年5月我院200例PE患者,根据病情严重程度分为轻度组(轻度PE患者,n=114)和重度组(重度PE患者,n=86),另选同期、同年龄段健康孕妇作为对照组(n=100)。比较三组血压[收缩压(SBP)、舒张压(DBP)]、24h尿蛋白定量(24h Upro)、钙离子(Ca⁺)、外周血miR-152、miR-210水平,分析外周血miR-152、miR-210水平与PE病情程度、血压、24h Upro及Ca⁺相关性。PE患者随访至妊娠结束,比较不同妊娠结局PE患者临床资料、外周血miR-152、miR-210水平,通过Lasso回归和Logistic回归分析预测因素与不良妊娠结局的关联性,通过受试者工作特征曲线(ROC)、临床决策曲线(DCA)评价外周血miR-152、miR-210对预测PE患者发生不良妊娠结局的价值及临床效用。结果: 重度组、轻度组、对照组SBP、DBP、24h Upro、外周血miR-152、miR-210水平比较,差异有统计学意义(P<0.05);外周血miR-152、miR-210水平与PE病情程度、血压、24h Upro呈正相关(P<0.05),与Ca⁺水平呈负相关(P<0.05);发生不良妊娠结局年龄、流产史、病情程度、SBP、DBP、24h Upro、Ca⁺、外周血miR-152、miR-210水平与未发生不良妊娠结局患者比较,差异有统计学意义(P<0.05);Lasso回归选出5个预测变量为病情程度、SBP、24h Upro、外周血miR-152、miR-210水平;Logistic回归显示,外周血miR-152、miR-210水平是PE患者发生不良妊娠结局的独立危险因素(P<0.05);ROC、DCA结果显示,外周血miR-152、miR-210联合预测PE患者发生不良妊娠结局具有良好的预测价值和临床效用。结论: 外周血miR-152、miR-210在PE患者中表达上调,且与病情程度、妊娠结局显著相关,其联合预测患者发生不良妊娠结局具有一定参考价值和临床效用。

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	赵泽燕
	杨亚君

关键词 ：外周血, miR-152, miR-210, 子痫前期, 病情程度, 妊娠结局

Abstract：Objective: To investigate the correlation between the expression levels of microRNA-152 (miR-152) and miR-210 in peripheral blood of pregnant women and the severity of preeclampsia (PE) and pregnancy outcomes. Methods: A total of 200 patients with PE admitted to our hospital from July 2018 to May 2022 were selected. According to the severity of the disease, they were divided into the mild group (mild PE patients, n=114) and the severe group (severe PE patients, n=86). Another 100 healthy pregnant women of the same age were selected as the control group. The blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], 24-hour urine protein quantitative (24 h Upro), calcium ion (Ca⁺), and peripheral blood miR-152 and miR-210 levels in the three groups were compared. The correlation between peripheral blood miR-152 and miR-210 levels and PE severity, blood pressure, 24 h Upro, and Ca⁺ was analyzed. The PE patients were followed up until the end of pregnancy, and the clinical data, peripheral blood miR-152, and miR-210 levels of PE patients with different pregnancy outcomes were compared. Lasso regression and Logistic regression were used to analyze the correlation between the predictive factors and adverse pregnancy outcomes. The receiver operating characteristic curve (ROC) and clinical decision curve (DCA) were used to evaluate the value and clinical utility of peripheral blood miR-152 and miR-210 in predicting adverse pregnancy outcomes in PE patients. Results: There were statistically significant differences in SBP, DBP, 24 h Upro, peripheral blood miR-152, and miR-210 levels among the severe group, mild group, and control group (P<0.05). The peripheral blood miR-152 and miR-210 levels were positively correlated with the severity of PE, blood pressure, and 24 h Upro (P<0.05), and negatively correlated with Ca⁺ level (P<0.05). The age, abortion history, severity, SBP, DBP, 24 h Upro, Ca⁺, and peripheral blood miR-152 and miR-210 levels of patients with adverse pregnancy outcomes were compared with those of patients without adverse pregnancy outcomes, and the differences were statistically significant (P<0.05). Lasso regression selected five predictive variables: severity, SBP, 24 h Upro, and peripheral blood miR-152 and miR-210 levels. Logistic regression showed that peripheral blood miR-152 and miR-210 levels were independent risk factors for adverse pregnancy outcomes in PE patients (P<0.05). The ROC and DCA results showed that the combination of peripheral blood miR-152 and miR-210 had good predictive value and clinical utility in predicting adverse pregnancy outcomes in PE patients. Conclusion: The expression of peripheral blood miR-152 and miR-210 is up-regulated in PE patients, and it is significantly correlated with the severity of the disease and pregnancy outcomes. The combination of the two has a certain reference value and clinical utility for predicting adverse pregnancy outcomes in patients.

Key words： Peripheral blood miR-152 miR-210 Preeclampsia Severity Pregnancy outcome

基金资助:山西省卫生健康委科研课题计划项目,(编号:201807D070924)

引用本文:

赵泽燕, 杨亚君. 孕妇外周血miR-152 miR-210与子痫前期病情程度及妊娠结局的相关性研究[J]. 河北医学, 2024, 30(5): 849-856.
ZHAO Zeyan, et al. Correlation of miR-152 and miR-210 in Peripheral Blood of Pregnant Women with the Extent of Pre-eclampsia and Pregnancy Outcome. HeBei Med, 2024, 30(5): 849-856.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.05.027 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I5/849

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