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目的探讨孕中期孕妇血清微小RNA-152(miRNA-152)和可溶性人类白细胞抗原G(s HLA-G)水平在预测子痫前期发生中的价值。方法选取2012年1月~2013年12月在镇江市妇幼保健院行常规产前检查的36例子痫前期患妇女为病例组,36例诊断为妊娠期高血压疾病(HDCP)的患者为HDCP组,36例正常妊娠妇女为对照组。采用实时荧光定量PCR技术检测妊娠中期(孕20~24周)血清miRNA-152表达水平,采用酶联免疫吸附试验(ELISA)检测血清s HLA-G水平。采用受试者工作特征曲线(ROC)确定预测界限值,预测发生子痫前期的敏感度和特异度。结果妊娠中期病例组血清miRNA-152和s HLA-G水平分别为(58.21±34.62)和(18.82±7.56)U/ml;HDCP组分别为(41.62±31.95)和(38.75±12.51)U/ml;对照组分别为(39.54±27.68)和(36.30±10.16)U/ml。病例组与对照组血清miRNA-152和s HLA-G水平比较,差异有统计学意义(P<0.05)。HDCP组与对照组血清miRNA-152和s HLA-G水平比较,差异无统计学意义(P>0.05)。取miRNA-152切割值为68.76时,预测子痫前期的敏感度和特异度分别为72.43%和63.81%;取s HLA-G切割值为16.72 U/ml时,预测子痫前期的敏感度和特异度分别为71.75%和61.55%;两者联合预测子痫前期的敏感度和特异度分别为80.52%和67.87%。结论检测妊娠中期孕妇血清miRNA-152和s HLA-G水平可作为预测子痫前期的有效指标,有较好的临床价值。
Objective To investigate the value of serum miRNA-152 (miRNA-152) and soluble human leukocyte antigen G (s HLA-G) levels in the prediction of preeclampsia in second trimester of pregnancy. Methods Thirty-six women with preeclampsia underwent routine prenatal examinations in Zhenjiang MCH hospital from January 2012 to December 2013 were selected as the case group and 36 patients with HDCP diagnosed as HDCP group , 36 normal pregnant women as the control group. Real-time fluorescence quantitative PCR was used to detect the expression of miRNA-152 in the second trimester of pregnancy (20-24 weeks of pregnancy), and the level of HLA-G was detected by enzyme linked immunosorbent assay (ELISA). The receiver operating characteristic curve (ROC) was used to determine the predictive threshold to predict the sensitivity and specificity of preeclampsia. Results The levels of serum miRNA-152 and s HLA-G in the second trimester of pregnancy were (58.21 ± 34.62) and (18.82 ± 7.56) U / ml respectively, while those in HDCP group were (41.62 ± 31.95) and (38.75 ± 12.51) U / ml ; The control group were (39.54 ± 27.68) and (36.30 ± 10.16) U / ml, respectively. The difference of serum miRNA-152 and s HLA-G between the case group and the control group was statistically significant (P <0.05). The serum levels of miRNA-152 and s HLA-G in HDCP group and control group had no significant difference (P> 0.05). The sensitivity and specificity of predicting preeclampsia were 72.43% and 63.81% when the cut value of miRNA-152 was 68.76, and the sensitivity and specificity of predicting preeclampsia when s HLA-G cut value was 16.72 U / ml The specificity was 71.75% and 61.55% respectively. The sensitivity and specificity of the two methods were 80.52% and 67.87% respectively. Conclusion Detection of serum miRNA-152 and s HLA-G levels in pregnant women in the second trimester can be used as an effective predictor of preeclampsia and has good clinical value.