天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (12): 1311-1315.doi: 10.11958/20211196

• 临床研究 • 上一篇    下一篇

微小RNA-18a联合子宫动脉血流参数对早发型子痫前期的预测价值

王勇 1，李传刚 2   

  1. 1南方医科大学南方医院江高院区办公室（邮编510515）；2南方医科大学南方医院超声医学科
  • 收稿日期:2021-05-20 修回日期:2021-09-21 出版日期:2021-12-15 发布日期:2021-12-27
  • 通讯作者: 王勇 E-mail:wangyong5236548@163.com
  • 作者简介:王勇（1970），男，硕士，主管技师，主要从事医学影像方面研究。E-mail：wangyong5236548@163.com
  • 基金资助:
    2018年度广东省医学科研基金项目（C2018068）

The predictive value of microRNA-18a combined with uterine artery blood flow parameters for early-onset preeclampsia

WANG Yong1, LI Chuan-gang2   

  1. 1 Jianggao District Office of Nanfang Hospital of Southern Medical University, Guangzhou 510515, China; 2 Department of Ultrasound Medicine, Nanfang Hospital, Southern Medical University
  • Received:2021-05-20 Revised:2021-09-21 Published:2021-12-15 Online:2021-12-27

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摘要： 目的 探讨微小RNA-18a（miR-18a）联合阻力指数（RI）、搏动指数（PI）、子宫动脉收缩期与舒张期血流速 度比值（S/D）等子宫动脉血流参数对早发型子痫前期（E-PE）的预测价值。方法 纳入孕检的孕妇628例根据其是 否发生E-PE分为E-PE组（34例）和对照组（594例）。采用彩色多普勒超声诊断仪检测RI、PI、S/D等参数，采用实时 定量PCR法检测血清miR-18a的相对表达水平。采用受试者工作特征曲线分析血清miR-18a、RI、PI、S/D对E-PE的 预测价值。结果 E-PE组的血清miR-18a相对表达水平低于对照组，RI、PI、S/D高于对照组（P＜0.05）；E-PE患者 血清miR-18a相对表达水平与RI、PI、S/D均呈负相关（P＜0.05）；血清miR-18a、RI、PI均可用于预测E-PE的发生风 险，曲线下面积分别为0.780（95%CI：0.727～0.832）、0.729（95%CI：0.644～0.814）、0.782（95%CI：0.695～0.870），而S/D 对E-PE的预测价值较低，曲线下面积为0.602（95%CI：0.496～0.708）。miR-18a联合PI对E-PE的预测价值较高，敏 感度为82.35%、特异度为83.84%，约登指数为0.662。结论 miR-18a在E-PE患者血清中异常低表达，且其表达水 平与RI、PI、S/D等子宫动脉血流参数均呈负相关，miR-18a联合PI对E-PE的预测价值较高。

关键词: 先兆子痫, 诊断；微RNAs, 超声检查, 多普勒, 彩色, 子宫动脉, 血流动力学, 早发型子痫前期, 微小RNA-18a

Abstract: Objective To explore the predictive value of microRNA-18a (miR-18a) combined with uterine artery blood flow parameters [resistance index (RI), pulse index (PI) and systolic phase velocity/diastolic phase velocity (S/D)] for the early-onset preeclampsia (E-PE). Methods A total of 628 pregnant women undergoing pregnancy checkups were selected in this study and divided into the E-PE group (n=34) and the control group (n=594) according to whether they developed E-PE. The relative expression of mir-18a was detected by real-time quantitative PCR, and RI, PI and S/D parameters were detected by color Doppler ultrasound diagnostic instrument. The predictive value of serum mir-18a, RI, PI and S/D to E-PE were analyzed by subject operating characteristic curve (ROC). Results The relative expression of miR- 18a in serum was lower in the E-PE group than that of the control group, and RI, PI, S/D were higher than those of the control group (P＜0.05). The relative expression of serum miR-18a was negatively correlated with RI, PI, and S/D in E-PE patients (P＜0.05). ROC analysis showed that serum miR-18a, RI and PI can be used to predict the risk of E-PE, and areas under the curve were 0.780 (95%CI: 0.727-0.832), 0.729 (95%CI: 0.644-0.814) and 0.782 (95%CI: 0.695-0.870), respectively. However, S/D had lower predictive value for E-PE, and the product under the curve was 0.602 (95%CI: 0.496- 0.708). miR-18a combined with PI showed a higher predictive value for E-PE, with a sensitivity of 82.35%, a specificity of 83.84%, and a Youden index of 0.662. Conclusion The serum expression of in miR-18a is abnormally low in E-PE patients, and its expression level is negatively correlated with uterine artery blood flow parameters such as RI, PI, and S/D. miR-18a combined with PI has a high predictive value for E-PE.

Key words: pre-eclampsia, diagnosis, microRNAs, ultrasonography, doppler, color, uterine artery, hemodynamics, early-onset preeclampsia, microRNA-18a

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