外周血miR-299和miR-23a在PE患者诊断及预后评估中的应用-东南大学学报医学版

外周血miR-299和miR-23a在PE患者诊断及预后评估中的应用

单位：1. 十堰市人民医院产科, 湖北十堰 442000;
2. 武汉亚心总医院妇科, 湖北武汉 430056

分类号：R714.244

出版年·卷·期（页码）：2024·43·第三期（403-409）

摘要：

目的:探讨外周血miR-299和miR-23a在子痫前期(PE)患者诊断及预后评估中的应用价值。方法:回顾性选取2020年1月至2023年1月在十堰市人民医院就诊的84例PE患者为研究对象(观察组),并随机选取同期73例正常孕妇作为对照组。检测血清中miR-299和miR-23a表达量。多因素Logistic回归模型分析PE孕妇的影响因素。采用ROC曲线分析miR-299和miR-23a对PE的诊断价值;通过Kaplan-Meier法分析miR-299和miR-23a表达水平对观察组孕期生存的影响。结果:观察组血清中miR-299和miR-23a水平(3.13±0.84、1.94±0.55)显著高于对照组(2.34±0.73、1.47±0.43)(P＜0.05)。Logistic回归分析显示,miR-299和miR-23a水平是PE发生的危险因素(P＜0.05)。miR-299和miR-23a两者联合诊断结果优于任何1项单独分析(Z_两项联合_-miR-299=2.067,P=0.038;Z_两项联合_-miR-23a=2.086,P=0.037)。患者中miR-299和miR-23a高表达组的死亡率显著高于低表达组(P＜0.05)。结论:PE患者血清中miR-299和miR-23a表达水平均上调,两者联合对PE有一定的诊断价值,且其表达水平与PE患者的预后密切相关。

Objective: To explore the application value of peripheral blood miR-299 and miR-23a in the diagnosis of preeclampsia(PE) patients and their prognostic evaluation. Methods: A total of 84 PE patients who visited Shiyan People's Hospital from January 2020 to January 2023 were retrospectively selected as the study subjects(observation group), and 73 normal pregnant women were randomly selected as the control group. The expression levels of miR-299 and miR-23a in serum were detected. Multivariate Logistic regression model was applied to analyze the influencing factors of PE in pregnant women. Receiver operating characteristic curve was applied to analyze the diagnostic value of miR-299 and miR-23a for PE; Kaplan-Meier method was applied to analyze the impact of miR-299 and miR-23a expression levels on pregnancy survival in the observation group. Results: The levels of miR-299 and miR-23a in the serum of the observation group(3.13±0.84, 1.94±0.55) were obviously higher than those of the control group(2.34±0.73, 1.47±0.43)(P＜0.05). Logistic regression showed miR-299 and miR-23a levels were risk factors for PE development(P＜0.05). The diagnostic results of miR-299 combined with miR-23a were superior to any individual analysis(Z_{combination-miR-299}=2.067, P=0.038; Z_{combination-miR-23a}=2.086, P=0.037). The mortality rate of patients with high expression of miR-299 and miR-23a was obviously higher than that of the low expression(P＜0.05). Conclusion: The expression levels of miR-299 and miR-23a in the serum of PE patients are both up-regulated, the combination of the two has certain diagnostic value for PE, and their expression levels are closely related to the prognosis of PE patients.

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