子痫前期患者中孕期子宫动脉血流多普勒联合血清miR-152检测的临床价值

The Clinical Value of Uterine Artery Blood Flow Doppler Combined with Serum miR-152 Detection in Preeclampsia Patients during Middle Pregnancy

目的探讨子宫动脉血流多普勒联合血清微小RNA-152(miR-152)检测在中孕期子痫前期(PE)患者预测诊断、疾病监测中的临床价值。方法按照纳入标准选取2016年1月2日-2017年1月10日在某院行常规产检的孕妇146例,均于孕中期(孕28周~32周)应用多普勒超声检测并记录子宫动脉的阻力指数(RI)、搏动指数(PI)以及收缩期峰值血流速度与舒张末期血流速度的比值(S/D);实时定量PCR(RT-q PCR)检测所有孕妇血清中mi R-152表达水平;随访所有患者孕晚期临床诊断结果及妊娠结局,回顾分析并应用受试者工作特征曲线(Receiver Operating Characteristic curve,ROC曲线)判断子宫动脉血流多普勒联合血清mi R-152表达在PE预测诊断中的临床价值。结果 146例孕产妇中共有27例发生PE(18.5%),所有孕妇妊娠结局良好;27例PE孕产妇(PE组)中孕期子宫动脉的RI、PI以及S/D值明显高于119例正常孕产妇(对照组);PE组中孕期血清miR-152表达水平高于对照组,以上差异均具有统计学意义(P<0.05)。子宫动脉血流多普勒联合血清miR-152表达应用于PE预测诊断的特异性为90.51%,优于诊断指标的单独应用。结论中孕期子宫动脉血流多普勒联合血清miR-152检测,两者相互弥补,对于PE的预测诊断具有一定临床应用价值。

Objectives To investigate the clinical value of uterine arterial blood flow Doppler combined with serum micro RNA-152（miR-152）detection in predictive diagnosis and disease surveillance in pre-eclampsia（PE）patients.Methods To select 146 pregnant women who accepted routine prenatal examination from January 2,2016 to January10,2017 in the hospital according to the inclusion criteria,and all pregnant women in the second trimester（gestational 28-32 weeks）using Doppler ultrasound detection and recording of the uterine artery resistance index（RI）,pulsatility index（PI）and systolic peak blood flow and end diastolic blood flow velocity ratio（S/D）. The levels of miR-152 in serum of all pregnant women were detected by real-time quantitative PCR（RT-q PCR）. All the patients were followed up for the third trimester of pregnancy diagnosis and pregnancy outcome. Retrospective analysis joint with ROC curve judge the clinical value of uterine arterial blood flow Doppler combined with serum miR-152 detection in the prediction of PE. Results There are a total of 27 cases of PE（18.5%）in 146 cases ofpregnant women,and all pregnant women with good pregnancy outcomes. The RI,PI and S/D values of uterine arteries during middle pregnancy in 27 cases of PE maternal（PE group）were significantly higher than 119 cases of normal pregnant women（control group）. The serum levels of miR-152 in PE group were higher than those in control group; the above differences were statistically significant（P〈0.05）. The specificity of uterine arterial flow Doppler combined with serum miR-152 expression in the prediction diagnosis of PE was 90.51%,which was superior to the single use of diagnostic indicators. Conclusions Uterine artery flow Doppler combined with serum miR-152 detection make up each other and has some clinical value for the prediction as well as the diagnosis of pre-eclampsia.