子宫动脉超声多普勒血流参数联合血清微小RNA-133b预测早发型子痫前期的应用价值分析

Analysis on application value of uterine artery Doppler flow parameters combined with serum microRNA-133b in predicting early-onset preeclampsia

目的探讨子宫动脉超声多普勒血流参数联合血清微小RNA-133b(miR-133b)预测早发型子痫前期的应用价值。方法选取2021年1月—2022年4月在锦州医科大学附属第一医院孕检的孕妇648例,在孕34周前诊断为早发型子痫前期纳入观察组(32例),未诊断为早发型子痫前期则纳入对照组(616例)。在孕16~20周应用超声检测两组子宫动脉血流参数,采用实时定量PCR法检测血清miR-133b相对表达量。结果观察组的阻力指数(RI)、子宫动脉收缩期与舒张期血流速度比值(S/D)、搏动指数(PI)以及血清miR-133b相对表达量分别为(0.58±0.13)、(2.21±0.54)、(0.97±0.18)、(1.58±0.22),均高于对照组[(0.47±0.15)、(1.91±0.52)、(0.81±0.13)、(1.21±0.24)],差异均有统计学意义(t=4.069,3.176,6.644,8.536,均P<0.05)。观察组孕妇血清miR-133b与RI、S/D、PI均呈正相关(均P<0.05)。血清miR-133b、RI、S/D、PI预测早发型子痫前期的ROC曲线下面积分别为0.812、0.707、0.645、0.744,其中血清miR-133b的预测价值最高。miR-133b联合PI预测早发型子痫前期的灵敏度、特异度、约登指数分别为84.38%、82.14%、0.665。结论在孕16~20周时血清miR-133b的相对表达量异常升高,预示早发型子痫前期的发生风险增大,对早发型子痫前期有一定的预测价值,且血清miR-133b联合PI可进一步提升预测价值。

Objective To explore the application value of uterine artery Doppler flow parameters combined with serum microRNA-133b(miR-133b)in predicting early-onset preeclampsia.Methods A total of 648 pregnant women receiving prenatal exmination in the First Affiliated Hospital of Jinzhou Medical University from January 2021 to April 2022 were selected and divided into observation group(32 cases diagnosed as early-onset preeclampsia before 34 weeks of pregnancy)and control group(616 cases not diagnosed as early-onset preeclampsia before 34 weeks of pregnancy).From the 16th to the 20th gestational weeks,uterine artery flow parameters in the two groups were detected,real-time quantitative PCR was used to detect the relative expression level of serum miR-133b.Results Resistance index(RI),the ratio of peak systolic velocity to end diastolic velocity(S/D),pulsatility index(PI),and relative expression level of serum miR-133b in observation group were(0.58±0.13),(2.21±0.54),(0.97±0.18),and(1.58±0.22),respectively,which were higher than those in control group[(0.47±0.15),(1.91±0.52),(0.81±0.13),and(1.21±0.24),respectively],there were statistically significant differences(t=4.069,3.176,6.644,8.536,P<0.05).The serum miR-133b of pregnant women in observation group was positively correlated with RI,S/D,and PI(P<0.05).The areas under ROC curve of serum miR-133b,RI,S/D,and PI in predicting earlyonset preeclampsia were 0.812,0.707,0.645,and 0.744,respectively,of which serum miR-133b had the highest predictive value.The sensitivity,specificity,and Yodon index of miR-133b combined with PI in predicting early-onset preeclampsia were 84.38%,82.14%,and 0.665,respectively.Conclusion The abnormal increase of relative expression level of serum miR-133b at 16-20 weeks of pregnancy indicates that the risk of early-onset preeclampsia increases,which has a certain predictive value for early-onset preeclampsia.The combination of serum miR-133b and PI can further improve the predictive value.