子痫前期孕妇血清miR-135b-5p、miR-126-3p水平变化及其临床意义

doi:10.3760/cma.j.issn.1007-1245.2024.23.018

摘要/Abstract

摘要：

目的　探讨子痫前期（PE）孕妇血清miR-135b-5p、miR-126-3p水平变化及其临床意义。方法　采用回顾性研究，选取2020年2月至2022年2月陕西中医药大学第二附属医院收治的89例PE孕妇作为研究组［年龄（27.28±2.94）岁，体重指数（22.72±2.45）kg/m²］，另选取同期健康孕妇89例作为对照组［年龄（26.49±2.76）岁，体重指数（22.84±2.12）kg/m²］。89例PE孕妇根据病情严重程度分为轻度组58例、重度组31例；根据是否发生宫内窘迫、早产、新生儿窒息、胎儿死亡、低体重儿、巨大儿等不良妊娠结局，分为良好组（52例）和不良组（37例）。采用实时荧光定量聚合酶链式反应（qRT-PCR）法检测研究对象的血清miR-135b-5p、miR-126-3p表达水平；采用t检验、χ²检验进行统计比较；Pearson相关性分析PE患者血清miR-135b-5p、miR-126-3p水平与收缩压、舒张压和蛋白尿的相关性；多因素logistic回归分析影响PE程度的因素；重度PE孕妇诊断及不良妊娠结局预测价值采用受试者操作特征曲线（ROC）进行分析。结果　研究组血清miR-135b-5p、miR-126-3p水平分别为0.69±0.14、0.65±0.13，对照组分别为1.07±0.23、1.08±0.25，两组比较差异均有统计学意义（均P<0.05）；重度组血清miR-135b-5p、miR-126-3p水平分别为0.49±0.11、0.53±0.12，轻度组分别为0.79±0.15、0.71±0.14，两组比较差异均有统计学意义（均P<0.05）；妊娠结局不良组血清miR-135b-5p、miR-126-3p水平分别为0.53±0.12、0.52±0.11，良好组分别为0.81±0.18、0.75±0.15，两组比较差异均有统计学意义（均P<0.05）。miR-135b-5p与收缩压、舒张压和蛋白尿呈负相关（r=-0.492、-0.612、-0.522，均P<0.05），miR-126-3p与收缩压、舒张压和蛋白尿呈负相关（r=-0.519、-0.481、-0.626，均P<0.05）；多因素logistic回归分析得知，低水平miR-135b-5p、miR-126-3p是重度PE的危险因素（均P<0.05）；根据ROC分析得知，miR-135b-5p、miR-126-3p联合检测对重度PE孕妇诊断及不良妊娠结局预测的AUC分别为0.948、0.952，均高于单一指标检测（均P<0.05）。结论　PE孕妇血清miR-135b-5p、miR-126-3p表达水平下降，与病情发展、不良妊娠结局有关，联合检测对重度PE孕妇诊断及不良妊娠结局预测的价值较高。

关键词:

, 子痫前期, miR-135b-5p, miR-126-3p, 诊断, 妊娠结局

Abstract:

Objective　To investigate the changes of the serum levels of microRNA-135b-5p (miR-135b-5p) and microRNA-126-3p (miR-126-3p) in pregnant women with preeclampsia (PE) and their clinical significance. Methods　Adopting a retrospective study. From February 2020 to February 2022, 89 patients with PE treated at Second Hospital, Shaanxi University of Chinese Medicine were selected as a study group who were (27.28±2.94) years old and whose body mass index (BMI) was (22.72±2.45) kg/m²; 89 normal pregnant women were selected as a control group who were (26.49±2.76) years old and whose BMI was (22.84±2.12) kg/m². The patients were divided into a mild group (58 cases) and a severe group (31 cases) according to the severity of the disease. The patients were divided into a good group (52 cases) and a adverse group (37 cases) according to the adverse pregnancy outcomes a such as intrauterine distress, premature delivery, neonatal asphyxia, fetal death, low weight infants, macrosomia, etc. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was applied to detect the expression levels of miR-135b-5p and miR-126-3p. t and χ² tests were performed to compare the data between the two groups. Pearson correlation was carried out to analyze the correlation of the serum levels of miR-135b-5p and miR-126-3p with systolic blood pressure, diastolic blood pressure, and proteinuria in the patients. Multivariate logistic regression was used to analyze the factors affecting PE degree. The diagnostic value of the patients with severe PE and the predictive value of adverse pregnancy outcomes in the patients were analyzed using the receiver operating characteristic curve (ROC). Results　The serum levels of miR-135b-5p and miR-126-3p in the study group were lower than those in the control group (0.69±0.14 vs. 1.07±0.23 and 0.65±0.13 vs. 1.08±0.25), with statistical differences (both P<0.05). The serum levels of miR-135b-5p and miR-126-3p in the study group were lower than those in the mild group (0.49±0.11 vs. 0.79±0.15 and 0.53±0.12 vs. 0.71±0.14), with statistical differences (both P<0.05). The serum levels miR-135b-5p and miR-126-3p in the good group were lower than those in the adverse group (0.53±0.12 vs. 0.81±0.18 and 0.52±0.11 vs. 0.75±0.15), with statistical differences (both P<0.05). The Pearson correlation analysis showed that of miR-135b-5p was negatively correlated with systolic blood pressure, diastolic blood pressure, and proteinuria (r=-0.492, -0.612, and -0.522; all P<0.05); miR-126-3p was negatively correlated with systolic blood pressure, diastolic blood pressure, and proteinuria (r=-0.519, -0.481, and -0.626; all P<0.05). Multivariate logistic regression analysis revealed that low levels of miR-135b-5p and miR-126-3p were risk factors for severe PE (both P<0.05). According to the ROC analysis, the areas under the curves (AUC) of the combination of miR-135b-5p and miR-126-3p for the diagnosis of the patients with severe PE and the prediction of adverse pregnancy outcomes were 0.948 and 0.952, respectively, which were higher than those of either indicator (both P<0.05). Conclusion　The expression levels of miR-135b-5p and miR-126-3p in the serum of patients with PE decrease, and are related to the development of PE and adverse pregnancy outcomes. The combination of the two has high diagnostic value for patients with severe PE and predictive value for adverse pregnancy outcomes.

Key words:

Preeclampsia, MiR-135b-5p, MiR-126-3p, Diagnosis, Pregnancy outcomes

仝腊娟徐炜炜马萌王婧.

子痫前期孕妇血清miR-135b-5p、miR-126-3p水平变化及其临床意义 [J]. 国际医药卫生导报, 2024, 30(23): 3972-3977.

Tong Lajuan, Xu Weiwei, Ma Meng, Wang Jing.

Changes and clinical significance of serum levels of miR-135b-5p and miR-126-3p in pregnant women with preeclampsia [J]. International Medicine and Health Guidance News, 2024, 30(23): 3972-3977.

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