胎儿生长受限患者血清与胎盘miR-1227-3p、miR-212-3p的表达水平及其临床意义

doi:10.11958/20250839

天津医药 ›› 2025, Vol. 53 ›› Issue (7): 709-713.doi: 10.11958/20250839

胎儿生长受限患者血清与胎盘miR-1227-3p、miR-212-3p的表达水平及其临床意义

崔欢(), 高颖^△(), 杨俊娟, 郭莹, 叶青

郑州市妇幼保健院妇产科（邮编450000）

收稿日期:2025-03-05 修回日期:2025-05-08 出版日期:2025-07-15 发布日期:2025-07-21
通讯作者: ^△E-mail：33233837@qq.com
作者简介:崔欢（1988），女，主治医师，主要从事胎儿生长受限方面研究。E-mail：823573248@qq.com
基金资助:
郑州市医疗卫生领域科技创新指导计划项目(2024YLZDJH346)

Expression levels and clinical significance of miR-1227-3p and miR-212-3p in serum and placenta in puerperas with fetal growth restriction

CUI Huan(), GAO Ying^△(), YANG Junjuan, GUO Ying, YE Qing

Department of Obstetrics and Gynecology, Zhengzhou Maternal and Child Health Hospital, Zhengzhou 450000, China

Received:2025-03-05 Revised:2025-05-08 Published:2025-07-15 Online:2025-07-21
Contact: ^△E-mail：33233837@qq.com

崔欢, 高颖, 杨俊娟, 郭莹, 叶青. 胎儿生长受限患者血清与胎盘miR-1227-3p、miR-212-3p的表达水平及其临床意义[J]. 天津医药, 2025, 53(7): 709-713.

CUI Huan, GAO Ying, YANG Junjuan, GUO Ying, YE Qing. Expression levels and clinical significance of miR-1227-3p and miR-212-3p in serum and placenta in puerperas with fetal growth restriction[J]. Tianjin Medical Journal, 2025, 53(7): 709-713.

摘要/Abstract

摘要：

目的探究胎儿生长受限（FGR）患者血清和胎盘组织中微小核糖核酸（miR）-1227-3p、miR-212-3p的表达水平及其临床意义。方法纳入确诊为FGR并完成分娩的产妇120例为研究组，根据病情严重程度分为轻度组72例和重度组48例，另择同期产检并完成分娩的健康产妇120例为对照组。采用qRT-PCR检测血清和胎盘组织中miR-1227-3p、miR-212-3p的表达水平；记录2组妊娠结局，包括新生儿体质量、1 min Apgar评分、胎盘质量和胎盘体积。结果研究组血清和胎盘miR-1227-3p表达水平、新生儿体质量、1 min Apgar评分、胎盘质量、胎盘体积均低于对照组，血清和胎盘miR-212-3p表达水平高于对照组（P<0.05）。重度组血清和胎盘miR-1227-3p表达水平低于轻度组，miR-212-3p表达水平高于轻度组（P<0.05）。血清和胎盘miR-1227-3p表达水平与新生儿体质量、1 min Apgar评分、胎盘质量、胎盘体积呈正相关，血清和胎盘miR-212-3p表达水平与上述指标呈负相关（P<0.01）。多因素Logistic回归分析显示，血清和胎盘miR-212-3p表达水平升高为FGR的危险因素，血清和胎盘miR-1227-3p表达水平、新生儿体质量、1 min Apgar评分、胎盘质量、胎盘体积增加为保护因素（P<0.05）。受试者工作特征（ROC）曲线分析结果显示，联合检测血清和胎盘miR-1227-3p、miR-212-3p对FGR的诊断价值优于单独诊断。结论 FGR产妇血清和胎盘miR-1227-3p表达水平降低，miR-212-3p表达水平升高，二者联合检测对临床诊断FGR有较高价值。

关键词: 胎儿生长迟缓, 胎盘, 血清, 妊娠结局, miR-1227-3p, miR-212-3p

Abstract:

Objective To investigate the expression levels and clinical significance of serum and placental microRNA (miR) -1227-3p and miR-212-3p in puerperas with fetal growth restriction (FGR). Methods A total of 120 puerperas diagnosed with FGR and completed delivery in our hospital were included as the study group. Patients were assigned into the mild group (n=72) and the severe group (n=48) according to the severity of their condition. Another 120 healthy puerperas who underwent prenatal check ups and delivered during the same period in our hospital were included as the control group. QRT-PCR was used to detect serum and placental miR-1227-3p and miR-212-3p. The pregnancy outcomes of both groups were recorded, including neonatal weight, 1min Apgar score, placental weight and placental volume. Results Serum and placental miR-1227-3p expression levels, neonatal weight, 1 min Apgar score, placental weight and placental volume were significantly lower in the study group than those of the control group (P<0.05), while serum and placental miR-212-3p expression levels were significantly higher than those of the control group (P<0.05). The expression levels of miR-1227-3p in serum and placenta of the severe group were obviously lower than those of the mild group (P<0.05), while the expression level of miR-212-3p was obviously higher than those of the mild group (P<0.05). The expression levels of miR-1227-3p in serum and placenta were positively correlated with neonatal weight, 1 min Apgar score, placental weight and placental volume, and the expression levels of miR-212-3p in serum and placenta were negatively correlated with the above indicators (P<0.05). Multivariate Logistic regression analysis revealed that elevated serum and placental miR-212-3p levels were risk factors for FGR (P<0.05), and increased serum and placental miR-1227-3p, neonatal weight, 1 min Apgar, placental weight and placental volume were protective factors (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the diagnostic value of combined detection of serum and placenta miR-1227-3p and miR-212-3p levels for FGR was better than that of single diagnosis. Conclusion The combined detection of miR-1227-3p and miR-212-3p in serum and placenta of FGR puerperas has certain value in the clinical diagnosis of FGR.

Key words: fetal growth retardation, placenta, serum, pregnancy outcome, miR-1227-3p, miR-212-3p

中图分类号:

R714.43

图/表 11

参考文献 22

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基因名称	引物序列（5′→3′）	产物大小/bp
miR-1227-3p	上游：AGGACGGCTCCTCTAACCAT 下游：AGCGGCTCCACAAGTAAGAC	183
miR-212-3p	上游：AACCAGCGCATGGACAGTTA 下游：GACTTGACCACCGAACCCAT	178
U6	上游：CTCGCTTCGGCAGCACA 下游：ACGCTTCACGAATTTGCG	163

基因名称	引物序列（5′→3′）	产物大小/bp
miR-1227-3p	上游：AGGACGGCTCCTCTAACCAT 下游：AGCGGCTCCACAAGTAAGAC	183
miR-212-3p	上游：AACCAGCGCATGGACAGTTA 下游：GACTTGACCACCGAACCCAT	178
U6	上游：CTCGCTTCGGCAGCACA 下游：ACGCTTCACGAATTTGCG	163

组别	n		年龄/岁		BMI/（kg/m²）		身高/cm	分娩孕周/周
对照组	120		28.67±3.52		27.65±2.19		158.62±2.86	38.58±1.41
研究组	120		28.59±3.48		27.45±2.31		157.96±2.85	38.45±1.52
t或χ²			0.177		0.688		1.791	0.448
组别		分娩方式				孕次/次			产次/次
组别		顺产		剖宫产		孕次/次			产次/次
对照组		68（56.67）		52（43.33）		2.46±0.41			1.58±0.31
研究组		70（58.33）		50（41.67）		2.48±0.43			1.59±0.32
t或χ²		0.068				0.369			0.246

组别	n		年龄/岁		BMI/（kg/m²）		身高/cm	分娩孕周/周
对照组	120		28.67±3.52		27.65±2.19		158.62±2.86	38.58±1.41
研究组	120		28.59±3.48		27.45±2.31		157.96±2.85	38.45±1.52
t或χ²			0.177		0.688		1.791	0.448
组别		分娩方式				孕次/次			产次/次
组别		顺产		剖宫产		孕次/次			产次/次
对照组		68（56.67）		52（43.33）		2.46±0.41			1.58±0.31
研究组		70（58.33）		50（41.67）		2.48±0.43			1.59±0.32
t或χ²		0.068				0.369			0.246

组别	n	血清		胎盘
组别	n	miR-1227-3p	miR-212-3p	miR-1227-3p	miR-212-3p
对照组	120	1.01±0.21	1.01±0.24	1.02±0.30	1.00±0.27
研究组	120	0.54±0.12	1.47±0.25	0.56±0.16	1.56±0.29
t		21.287^＊	14.540^＊	14.821^＊	15.482^＊

胎儿生长受限患者血清与胎盘miR-1227-3p、miR-212-3p的表达水平及其临床意义

Expression levels and clinical significance of miR-1227-3p and miR-212-3p in serum and placenta in puerperas with fetal growth restriction

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组别	新生儿体质量/g	1 min Apgar 评分/分	胎盘质量/g	胎盘体积/cm³
对照组	3 324.58±189.64	8.64±0.42	524.68±40.25	689.52±86.45
研究组	2 286.24±186.20	8.04±0.34	432.76±35.62	524.39±76.18
t	42.798^＊	12.163^＊	18.734^＊	15.699^＊

指标	血清		胎盘
指标	miR-1227-3p	miR-212-3p	miR-1227-3p	miR-212-3p
新生儿体质量	0.495^＊＊	-0.501^＊＊	0.510^＊＊	-0.478^＊＊
1 min Apgar 评分	0.486^＊＊	-0.491^＊＊	0.495^＊＊	-0.497^＊＊
胎盘质量	0.487^＊＊	-0.482^＊＊	0.491^＊＊	-0.483^＊＊
胎盘体积	0.464^＊＊	-0.460^＊＊	0.475^＊＊	-0.461^＊＊

变量	β	SE	Wald χ²	P	OR	OR 95%CI
血清miR-1227-3p	-0.887	0.315	7.924	0.005	0.412	0.222~0.764
血清miR-212-3p	0.719	0.341	4.449	0.035	2.053	1.052~4.005
胎盘miR-1227-3p	-0.909	0.289	9.889	0.002	0.403	0.228~0.710
胎盘miR-212-3p	0.453	0.209	4.698	0.030	1.573	1.044~2.369
新生儿体质量	-1.155	0.254	20.684	<0.001	0.315	0.191~0.518
1 min Apgar评分	-1.187	0.286	17.238	<0.001	0.305	0.174~0.534
胎盘质量	-1.178	0.301	15.307	<0.001	0.308	0.171~0.556
胎盘体积	-1.130	0.317	12.710	<0.001	0.323	0.174~0.601
常数项	-1.012	0.279	9.078	0.002	0.337

指标	AUC	95%CI	敏感度/ %	特异度/ %	截断值	约登指数
miR-1227-3p	0.856	0.806~0.905	78.34	84.28	0.702	0.626
miR-212-3p	0.849	0.801~0.897	80.64	79.34	1.308	0.599
联合检测	0.912	0.874~0.949	87.62	78.08	-	0.657

指标	AUC	95%CI	敏感度/ %	特异度/ %	截断值	约登指数
miR-1227-3p	0.846	0.796~0.897	76.85	82.38	0.725	0.592
miR-212-3p	0.851	0.804~0.898	78.36	78.62	1.386	0.570
联合检测	0.920	0.884~0.955	85.67	77.39	-	0.631

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组别	n	血清		胎盘
组别	n	miR-1227-3p	miR-212-3p	miR-1227-3p	miR-212-3p
轻度组	72	0.76±0.17	1.28±0.23	0.78±0.23	1.35±0.26
重度组	48	0.21±0.05	1.76±0.27	0.22±0.06	1.87±0.34
t		21.769^＊	10.441^＊	16.478^＊	9.476^＊

组别	n	血清		胎盘
组别	n	miR-1227-3p	miR-212-3p	miR-1227-3p	miR-212-3p
轻度组	72	0.76±0.17	1.28±0.23	0.78±0.23	1.35±0.26
重度组	48	0.21±0.05	1.76±0.27	0.22±0.06	1.87±0.34
t		21.769^＊	10.441^＊	16.478^＊	9.476^＊