凝血指标及胎盘组织miR-26b表达与早发型子痫前期血管生成的相关性分析

Correlation analysis of blood coagulation parameters and expression of miR-26b in placental tissues with angiogenesis in early-onset preeclampsia

目的探究妊娠期凝血指标及胎盘组织miR-26b表达与早发型子痫前期(EOP)血管生成的相关性。方法选取2019年11月至2021年11月邯郸市中心医院收治的60例EOP患者为研究组,其中,轻度EOP患者28例(设为轻症组),重度EOP患者32例(设为重症组),另选取同期健康孕妇50例为对照组。对比三组凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)水平、胎盘组织微小RNA-26b(miR-26b)表达量及微血管密度。采用Pearson检验分析PT、APTT、FIB、胎盘组织miR-26b表达量与微血管密度间的相关性。采用多因素Logistic回归分析筛选孕妇发生EOP的独立影响因素,构建列线图预测模型并进行评价。结果重症组PT、APTT水平及微血管密度计数明显低于对照组和轻症组,轻症组显著低于对照组;而FIB、miR-26b表达量明显高于轻症组和对照组,轻症组高于对照组(P<0.05)。Pearson检验结果显示,PT、APTT与微血管密度呈明显正相关(P<0.05),FIB、胎盘组织miR-26b表达量与微血管密度呈明显负相关(P<0.05)。年龄、妊娠高血压、维生素E缺乏、FIB及胎盘组织miR-26b表达量是孕妇发生EOP的独立危险因素,PT、APTT是其保护因素(P<0.05)。结论EOP患者妊娠期PT、APTT水平下降,FIB、胎盘组织miR-26b表达量水平升高,均与血管生成关系密切。

Objective To investigate the correlation between coagulation indexes during pregnancy and the expression of miR-26b in placental tissues and angiogenesis in early onset preeclampsia(EOP). Methods A total of 60 patients with EOP admitted to Handan Central Hospital from November 2019 to November 2021 were selected as the study group, including 28 patients with mild EOP(set as mild group), 32 patients with severe EOP(set as severe group), and 50 healthy pregnant women during the same period were selected as the control group. Comparison to three groups of prothrombin time(PT), activated partial thromboplastin time(APTT), fibrinogen(FIB), expression of microRNA-26b(miR-26b) in placental tissue and microvascular density. Pearson test was used to analyze the correlation between the expression levels of PT, APTT, FIB and placental miR-26b and microvascular density. Multivariate Logistic regression analysis was used to screen the independent influencing factors of EOP in pregnant women, and a nomogram prediction model was constructed and evaluated. Results PT and APTT levels and microvascular density count in severe group were significantly lower than those in control group and mild group, and those in mild group were significantly lower than those in control group. The expression levels of FIB and miR-26b in mild patients were significantly higher than those in control group and mild patients(P<0.05). Pearson test results showed that PT and APTT were significantly positively correlated with microvessel density(P<0.05), and miR-26b expression levels in FIB and placenta were significantly negatively correlated with microvessel density(P<0.05). Age, gestational hypertension, vitamin E deficiency and miR-26b expression in FIB and placenta were independent risk factors for EOP in pregnant women, PT and APTT were protective factors(P<0.05). Conclusion In EOP patients, PT and APTT levels decreased during pregnancy, and the expression levels of FIB and placental miR-26b increased, which were closely related to angiogenesis.