血清GATA6和SMAD3表达水平对孕中期胎儿心血管畸形的诊断价值

The diagnostic value of serum GATA6 and SMAD3 expression levels for fetal cardiovascular malformations in the second trimester of pregnancy

目的探究孕中期孕妇血清GATA结合6(GATA6)、SMAD同源物3(SMAD3)表达水平对胎儿心血管畸形的诊断价值。方法选取2017年6月至2023年6月北部战区总医院收治的有高危胎儿心血管畸形风险的孕中期孕妇203例作为研究对象,根据随访结果,45例孕妇胎儿确诊为心血管畸形(疾病组),158例孕妇胎儿心脏发育正常(对照组)。采用荧光定量PCR法和酶联免疫吸附(ELISA)法分别检测孕中期孕妇血清GATA6 mRNA、SMAD3表达水平。受试者工作特征(ROC)曲线分析孕中期孕妇血清GATA6 mRNA、SMAD3对胎儿心血管畸形的诊断价值。结果疾病组孕妇血清GATA6 mRNA、SMAD3表达水平均低于对照组,差异有统计学意义(t值分别为4.210、7.185,P<0.05);孕中期孕妇血清GATA6 mRNA、SMAD3二者联合诊断胎儿心血管畸形的曲线下面积(AUC)为0.95,优于各自单独诊断(Z值分别为5.41、5.23,P<0.05);联合诊断的灵敏度和特异度分别为97.78%、79.11%。结论胎儿心血管畸形的孕中期孕妇血清GATA6 mRNA、SMAD3表达水平均较低,二者联合检测对胎儿心血管畸形有较好的诊断价值。

Objective To explore the diagnostic value of serum GATA binding 6(GATA6)and SMAD homolog 3(SMAD3)expression levels in the second trimester of pregnancy for fetal cardiovascular malformations.Methods A total of 203 pregnant women with high-risk fetal cardiovascular malformations in the second trimester who were admitted to the General Hospital of Northern Theater Command from June 2017 to June 2023 were selected as the study objects.According to the follow-up results,45 pregnant women s fetuses were diagnosed with cardiovascular malformations(disease group),and 158 pregnant women s fetuses with normal heart development(control group).The expression levels of GATA6 mRNA and SMAD3 in the serum in the second trimester of pregnancy were detected using fluorescence quantitative PCR and enzyme-linked immunosorbent assay(ELISA)methods,respectively.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum GATA6 mRNA and SMAD3 in the second trimester of pregnancy women for fetal cardiovascular malformations.Results The expression levels of serum GATA6 mRNA and SMAD3 in the disease group were lower than those in the control group,and the differences were statistically significant(t=4.210 and 7.185,respectively,P<0.05);The area under the curve(AUC)of the combined diagnosis of fetal cardiovascular malformations by serum GATA6 mRNA and SMAD3 in the second trimester was 0.95,which was better than the respective individual diagnoses(Z=5.41 and 5.23,respectively,P<0.05).The sensitivity and specificity of combined diagnosis were 97.78%and 79.11%,respectively.Conclusion The expression levels of serum GATA6 mRNA and SMAD3 in pregnant women with fetal cardiovascular malformations in the second trimester are low,and the combined detection of the two has a good diagnostic value for fetal cardiovascular malformations.