重度子痫前期患者血清miR-134-5p和Let-7a表达水平及临床意义

The expression levels and clinical significance of serum miR-134-5p and Let-7a in patients with severe preeclampsia

目的 分析重度子痫前期(Severe preeclampsia, SPE)患者血清微小RNA(microRNA,miR)-134-5p和Let-7a表达水平及临床意义。方法 选取已确诊妊娠高血压孕妇100例为研究对象,其中子痫前期(preeclampsia, PE)孕妇40例、SPE孕妇60例。同期在本院孕检的正常妊娠女性100例为对照组。实时荧光定量PCR(real-time quantitative pcr, qRT-PCR)法检测血清中miR-134-5p、Let-7a相对表达水平;Pearson法进行相关性分析;多因素Logistic回归分析SPE的影响因素。结果 对照组、PE组、SPE组血清中miR-134-5p、Let-7a水平比较,差异有统计学意义(F=288.012、251.780,P<0.001);其中,PE组、SPE组血清中miR-134-5p、Let-7a水平均高于对照组(P<0.05),SPE组血清中miR-134-5p、Let-7a水平均高于PE组(P<0.05)。PE组和SPE组收缩压、舒张压、尿蛋白、肌酐、乳酸脱氢酶、血尿素氮(blood urea nitrogen, BUN)、平均血小板体积(mean platelet volume, MPV)、白蛋白(albumin, ALB)水平、新生儿身长、新生儿体重比较差异有统计学意义(均P<0.05)。PE患者血清中miR-134-5p表达水平与新生儿身长呈负相关(r=-0.608,P<0.05),与收缩压、尿蛋白、乳酸脱氢酶呈正相关(r=0.613、0.548、0.635,均P<0.05);Let-7a表达水平与新生儿身长呈负相关(r=-0.587,P<0.05),与收缩压、尿蛋白、乳酸脱氢酶呈正相关(r=0.624、0.571、0.478,均P<0.05),PE患者血清miR-134-5p、Let-7a表达水平呈显著正相关(r=0.623,P<0.001)。收缩压(OR=1.527,95%CI:1.042~2.238)、尿蛋白(OR=1.825,95%CI:1.010~3.299)、miR-134-5p(OR=1.467,95%CI:1.023~2.104)、Let-7a(OR=1.523,95%CI:1.010~2.299)均是SPE发生的危险因素(P<0.05)。结论 SPE孕妇血清miR-134-5p、Let-7a水平显著升高,miR-134-5p、Let-7a与新生儿身长、收缩压、尿蛋白、乳酸脱氢酶具有相关性,是SPE发生的影响因素。

Objective To analyze the expression levels and clinical significance of serum microRNA(miR)-134-5p and Let-7a in patients with severe preeclampsia(SPE).Methods In total,100 pregnant women with gestational hypertension diagnosed were selected as the research subjects,including 40 pregnant women with preeclampsia(PE)and 60 pregnant women with SPE.Another 100 normal pregnant women who underwent pregnancy examination in our hospital during the same period served as the control group.The real-time quantitative PCR(qRT-PCR)method was applied to detect the relative expression levels of serum miR-134-5p and Let-7a.Pearson method was applied for correlation analysis,and multivariate Logistic regression was applied to analyze the influencing factors of SPE.Results There was a significant difference in the serum levels of miR-134-5p and Let-7a among the control group,PE group,and SPE group(F=288.012,251.780,P<0.001).Among them,the serum levels of miR-134-5p and Let-7a in the PE group and SPE group were higher than those in the control group(P<0.05),while the serum levels of miR-134-5p and Let-7a in the SPE group were higher than those in the PE group(P<0.05).There were significant differences between the PE group and the SPE group with respect to systolic blood pressure(SBP),diastolic blood pressure,urinary protein,creatinine,lactic dehydrogenase,blood urea nitrogen(BUN),mean platelet volume(MPV),albumin(ALB)levels,neonatal length,and neonatal body mass(all P<0.05).The serum expressionlevel of miR-134-5p in PE patients was negatively correlated with neonatal length(r=-0.608,P<0.05),but positively correlated with SBP,urinary protein,and lactic dehydrogenase(r=0.613,0.548,0.635,all P<0.05).The expression level of Let-7a was negatively correlated with neonatal length(r=-0.587,P<0.05),and positively correlated with SBP,urinary protein,and lactic dehydrogenase(r=0.624,0.571,0.478,all P<0.05).The serum expression levels of miR-134-5p and Let-7a in PE patients were significantly and positively correlated(r=0.623,P<0.001).SBP(OR=1.527,95%CI:1.042-2.238),urinary protein(OR=1.825,95%CI:1.010-3.299),miR-134-5p(OR=1.467,95%CI:1.023-2.104),and Let-7a(OR=1.523,95%CI:1.010-2.299)were all risk factors for SPE(P<0.05).Conclusion The serum levels of miR-134-5p and Let-7a in pregnant women with SPE are remarkably elevated.MiR-134-5p and Let-7a are correlated with neonatal length,SBP,urinary protein,and lactic dehydrogenase,and are influencing factors for the occurrence of SPE.