血清铁蛋白联合miR-182检测评估宫内感染及新生儿预后价值

Values of serum ferritin level combined with miR-182 expression level for diagnosing intrauterine infection of pregnant women and for assessing neonatal prognosis

目的:分析血清铁蛋白(FP)联合微小RNA-182(miR-182)检测对宫内感染诊断及新生儿预后评估价值。方法:选取2016年10月—2019年8月本院收治的绒毛膜羊膜炎产妇52例(感染组),住院分娩或晚期妊娠引产的健康产妇50例(对照组),检测两组产妇血清FP及miR-182相对表达量,采用接受者操作特征曲线(ROC)评价两指标对宫内感染诊断价值及评估新生儿不良结局效能,采用Pearson相关性分析二者与新生儿Apgar评分相关性。结果:感染组血清FP水平(298.48±48.72μg/L)及miR-182相对表达量(2.38±0.70)均高于对照组(P<0.05)。ROC曲线分析,血清铁蛋白水平以241.11μg/L为截断值时诊断宫内感染的灵敏度为94.2%,特异度为90.0%,ROC曲线下面积为0.950(95%CI:0.910~0.990,P<0.001);miR-182相对表达量以1.82为截断值时诊断宫内感染的灵敏度为80.8%,特异度为90.0%,ROC曲线下面积为0.889(95%CI:0.823~0.955,P<0.001),两项指标联合检测诊断宫内感染的灵敏度为92.3%,特异度为80.0%,ROC曲线下面积为0.990(95%CI:0.978~1.000,P<0.001)优于单项检测。感染组新生儿宫内感染、新生儿呼吸窘迫综合征、新生儿宫内感染性肺炎、围产期脑损伤、新生儿死亡、新生儿Apgar评分<7分的发生率均高于对照组(P<0.05),新生儿早产、新生儿宫内窘迫的发生率两组无差异(P>0.05);Pearson相关性分析,产妇血清FP水平及miR-182均与新生儿Apgar评分均呈负相关(P<0.05)。结论:血清FP联合miR-182检测对产妇宫内感染有较好诊断价值,两指标与新生儿Apgar评分呈负相关性,提示临床上可根据检测水平评估宫内感染及新生儿预后,从而早期采取针对性诊疗措施。

Objective:To investigate the value of serum ferritin level combined with miR-182 level detection for of pregnant women and for assessing neonatal prognosis.Methods:52 pregnant women with chorioamnionitis were selected in study group and 50 healthy pregnant women were selected in control group from October 2016 to August 2019.The levels of serum ferritin and miR-182 relative expression level of the women in the two groups were measured.The receiver operating characteristic curve(ROC)was used to evaluate the value of the ferritin level and miR-182 expression level for diagnosing intrauterine infection of the women and for assessing neonatal prognosis.Pearson correlation analysis was used to analyze the correlation between the ferritin level and miR-182 expression level and Apgar score of the newborns.Results:The serum ferritin level(298.48±48.72μg/L)and mir-182 relative expression level(2.38±0.70)of the women in the study group were significant higher than those of the women in the control group(P<0.05).ROC curve analysis showed that when serum ferritin level(241.11μg/L)as the cut-off value,the sensitivity,the specificity,and area under of ROC curve of serum ferritin level for diagnosing intrauterine infection were 94.2%,90.0%,and 0.950(95%CI:0.910-0.990,P<0.001).When the relative expression of Mir-182(1.82)of the women as the cut-off value,the sensitivity,the specificity and area under of ROC curve relative expression of Mir-182 for diagnosing intrauterine infection were 80.8%,90.0%,and 0.889(95%CI:0.823-0.955,P<0.001).The sensitivity,the specificity,and area under of ROC curve of the combined detections of the serum ferritin level and the relative expression of Mir-182 for diagnosing intrauterine infection were 92.3%,80.0%,and 0.990(95%CI:0.978-1.000,P<0.001),which diagnostic value was significant better than that of the serum ferritin level or the relative expression of Mir-182 alone.The incidences of neonatal intrauterine infection,respiratory distress syndrome,infectious pneumonia,perinatal brain injury,death,and Apgar score<7 points in the study group were significant higher than those in the control group(P<0.05),but there were no significant differences in the incidences of neonatal preterm birth and intrauterine distress between the two groups(P>0.05).Pearson correlation analysis showed that maternal serum ferritin level and Mir-182 level were negatively correlated with the neonatal Apgar score(P<0.05).Conclusion:The detection of the serum ferritin level combined with miR-182 level for diagnosing intrauterine infection has good diagnostic value.Both of the increase of the serum ferritin level and miR-182 expression level has negatively correlation with the Apgar score of the newborn.It is suggested that intrauterine infection of the pregnant women and neonatal prognosis can be evaluated according to the serum ferritin level and miR-182 expression,so as to conduct targeted treatment early.