子痫前期血清miR-16、miR-210表达与妊娠结局相关性分析

Correlation between serum miR-16,miR-210 expression and pregnancy outcome in preeclampsia

目的 探讨子痫前期患者血清微小RNA-16(miR-16)、血清微小RNA-20(miR-210)表达情况及其与妊娠结局的相关性。方法 前瞻性选取2020年1月至12月柳州市妇幼保健院产科收治的85例子痫前期患者为病例组,根据病情严重程度分为轻度子痫前期组45例和重度子痫前期组40例。另选取同期85名健康妊娠的孕妇为对照组。病例组与对照组均采用荧光实时定量聚合酶链反应(qRT-PCR)法检测血清miR-16、miR-210表达情况。随访病例组妇女的妊娠结局,并采用多因素Logistic回归模型分析血清miR-16、miR-210表达与妊娠结局的相关性。分析血清miR-16、miR-210对子痫前期患者妊娠不良结局的预测价值。结果 重度子痫前期组的收缩压、舒张压、平均动脉压、24 h尿蛋白高于轻度子痫前期组,轻度子痫前期组的以上指标又高于对照组,3组间差异有统计学意义(P<0.05)。重度子痫前期组的血清miR-16、miR-210的表达均高于轻度子痫前期组,轻度子痫前期组又高于对照组,3组间差异有统计学意义(P<0.05)。miR-16、miR-210高表达组的不良妊娠结局发生率为43. 18%、41. 86%,均高于低水平组(19. 21%、21. 43%),差异有统计学意义(P<0.05)。多因素Logistic回归模型分析显示,miR-16、miR-210高表达是子痫前期患者妊娠不良结局的独立风险因素(OR=4. 914,95%CI=3. 249~7. 430;OR=2. 298,95%CI=1. 541~3. 428;OR=2. 573,95%CI=0. 919~7. 199;OR=3. 758,95%CI=1. 871~7. 552,P<0.05)。ROC曲线结果显示,miR-16、miR-210联合检测对不良妊娠结局的预测高于单独检测,差异有统计学意义(P<0.05)。结论子痫前期患者的miR-16、miR-210表达水平较高,且病情越严重表达水平越高,两项指标高水平表达可能成为妊娠不良结局的预测辅助指标。

Objective To investigate the expression of serum microrna-16(miR-16)and serum microrna-20(miR-210)in patients with preeclampsia and their correlation with pregnancy outcome.Methods A total of 85 patients with preeclampsia treated in the Department of Obstetrics,Liuzhou Maternal and Child Health Hospital from January to December 2020 were prospectively selected as the case group.According to the severity of the disease,they were divided into 45 cases in the mild group and 40 cases in the severe group.85 healthy pregnant women in the same period were selected as the control group.The expressions of serum miR-16 and miR-210 were detected by fluorescence real-time quantitative polymerase chain reaction(qRT-PCR)in both case group and control group.The pregnancy outcomes of women in the case group were followed up,and the correlation between the expression of serum miR-16 and miR-210 and pregnancy outcomes was analyzed by multivariate Logistic regression model.The predictive value of serum miR-16 and miR-210 in preeclampsia patients with adverse pregnancy outcomes was analyzed.Results The systolic blood pressure,diastolic blood pressure,mean arterial pressure and 24 h urinary protein in severe PE group were higher than those in mild PE group,and the above indexes in mild PE group were higher than those in the control group,the difference among the three groups was statistically significant(P<0.05).The expressions of serum miR-16 and miR-210 in severe preeclampsia group were higher than those in mild preeclampsia group,and those in mild preeclampsia group were higher than those in the control group,the difference among the three groups was statistically significant(P<0.05).The adverse pregnancy outcome in the high expression group of miR-16 and miR-210 were 43.18%,41.86%,significantly higher than those in the low expression group(19.21%,21.43%),the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the high expression of miR-16 and miR-210 was an independent risk factor for adverse pregnancy outcome in patients with preeclampsia(OR=4.914,95%CI=3.249~7.430;OR=2.298,95%CI=1.541~3.428;OR=2.573,95%CI=0.919~7.199;OR=3.758,95%CI=1.871~7.552,P<0.05).Conclusion The expression levels of miR-16 and miR-210 in patients with preeclampsia are higher,and the more serious the condition is,the higher the expression level is.The high expression of the two indexes may be an auxiliary index to predict the adverse outcome of pregnancy.