母血microRNA-520α水平与胎儿心脏缺陷关系的研究

Study on the relationship between maternal microRNA-520α level and fetal heart defects

目的探讨母血microRNA-520α水平对胎儿心脏缺陷的早期诊断价值及其临床意义。方法选取2016年5月~2018年4月怀有心脏缺陷胎儿孕妇23例(心脏缺陷组),同期产检的神经管畸形胎儿孕妇23例(神经管畸形组)和怀有正常胎儿孕妇30例(正常对照组)作为本文的主要研究对象,检测各组孕妇血液中的microRNA-520α水平,并通过ROC曲线分析评估母血microRNA-520α水平诊断胎儿心脏缺陷关系的价值。结果经分娩/引产证实胎儿心脏缺陷例数为22例,准确率为95.65%,误诊1例,漏诊率为4.35%。心脏畸形组的microRNA-520α水平(1.29±0.75)ng/ml,低于神经管畸形组的(1.81±0.95)ng/ml,显著低于正常对照组的(2.65±1.26)ng/ml,差异有统计学意义(P<0.05)。进一步的ROC曲线分析得出母血microRNA-520α水平诊断胎儿心脏缺陷的曲线下面积(area under curve,AUC)为0.854,在最佳临界值点对应的灵敏度、特异度分别为87%、71.7%,证明microRNA-520α对胎儿心脏缺陷的诊断效能较好。结论母血microRNA-520α水平对胎儿心脏缺陷具有诊断价值,且诊断准确性较好,可为胎儿心脏缺陷早期辅助评估提供客观参考。

Objective:To investigate the early diagnostic value and clinical significance of maternal microRNA-520αlevel in fetal heart defects.Methods:Twenty-three pregnant women with heart defects(from heart defect group)from May 2016 to April 2018 were enrolled.Twenty-three pregnant women with neural tube defects(neural tube malformation group)and 30 pregnant women with normal fetuses were diagnosed at the same time.(Normal control group)As the main research object in this paper,the microRNA-520αlevel in the blood of each group of pregnant women was detected,and the value of maternal blood microRNA-520αlevel in the diagnosis of fetal heart defect was evaluated by ROC curve analysis.Results:The number of fetal heart defects confirmed by delivery/induction was 22 cases,the accuracy rate was 95.65%,1 case was misdiagnosed,and the missed diagnosis rate was 4.35%.The level of microRNA-520αin the cardiac malformation group was(1.29±0.75)ng/ml,which was lower than that in the neural tube malformation group(1.81±0.95)ng/ml,which was significantly lower than that in the normal control group(2.65±1.26)ng/ml.The difference was statistically significant(P<0.05).Further ROC curve analysis showed that the area under the curve of the fetal blood microRNA-520αlevel for the diagnosis of fetal heart defects area under curve(AUC)was 0.854,and the sensitivity and specificity corresponding to the optimal cut-off point were 87%,71.7%,which proves that microRNA-520αhas a good diagnostic effect on fetal heart defects.Conclusion:Maternal microRNA-520αlevel has diagnostic value for fetal heart defects,and the diagnostic accuracy is good,which can provide an objective reference for early assessment of fetal heart defects.