血清miR-184、miR-513c-5p表达与复发性流产相关性研究及临床意义

Correlation study and clinical significance of serum miR-184 and miR-513c-5p expressions with recurrent spontaneous abortion

摘要

目的 研究血清微小RNA-184(miR-184)、微小RNA-513c-5p(miR-513c-5p)表达与复发性流产(RSA)相关性及临床意义.方法 选取2019年3月至2022年7月我院收治的67例RSA患者(RSA组)及67例正常早孕期女性(对照组),比较两组、RSA组血清miR-184、miR-513c-5p表达,将RSA组根据妊娠结局分为再次流产与未再次流产亚组,比较两亚组血清miR-184、miR-513c-5p表达.依次运用Pearson、受试者工作特征(ROC)曲线、临床决策分析曲线(DCA)、比值比(OR)进行相关性、预测效能、临床效用、危险度分析.结果 RSA组妊娠前、后血清miR-184、miR-513c-5p均高于对照组,且RSA组妊娠后高于妊娠前(P＜0.05);RSA组再次流产患者妊娠后血清miR-184、miR-513c-5p高于未再次流产患者(P＜0.05).RSA组妊娠前、后血清miR-184均与miR-513c-5p呈显著正相关(r＝0.800、0.750,P＜0.001);血清miR-184＋miR-513c-5p表达预测RSA再发流产的ROC曲线下面积(AUC)为0.901,高于单独的血清miR-184、miR-513c-5p(Z＝3.892、3.411,P＜0.05).采用该预测方案进行预测和干预,具有良好的临床效用.妊娠后血清miR-184高表达RSA患者再发流产的风险是低表达患者的7.407倍,血清miR-513c-5p高表达RSA患者再发流产的风险是低表达患者的18.125倍(P＜0.05).结论 血清miR-184、miR-513c-5p的高表达与RSA及其再妊娠结局有关,联合检测两者可为再妊娠结局的预测提供一定参考,从而指导做出进一步的决策与治疗.

Abstract

Objective To study the correlation and clinical significance of serum microRNA-184 (miR-184) and microRNA-513c-5p (miR-513c-5p) expression with recurrent spontaneous abortion (RSA). Methods We selected 67 RSA patients (RSA group) and 67 normal early pregnancy women (control group) treated in our hospital from March 2019 to July 2022. The serum expression of miR-184 and miR-513c-5p was compared between the two groups and within the RSA group. The RSA group was divided into two subgroups based on pregnancy outcomes: recurrent abortion and no recurrent abortion. Serum miR-184 and miR-513c-5p expression was compared between two subgroups. Pearson correlation, receiver operating characteristic (ROC) curve, clinical decision analysis (DCA), and odds ratio (OR) were used for correlation, predictive performance, clinical utility, and risk analysis. Results Serum miR-184 and miR-513c-5p levels in the RSA group before and after pregnancy were higher than those in the control group, and post-pregnancy levels were higher than pre-pregnancy levels in the RSA group (P＜0.05). Post-pregnancy serum miR-184 and miR-513c-5p levels were higher in recurrent abortion patients than in non-recurrent abortion patients within the RSA group (P＜0.05). Pre- and post-pregnancy serum miR-184 levels were significantly positively correlated with miR-513c-5p levels in the RSA group (r＝0.800, 0.750, P＜0.001). The area under the ROC curve (AUC) for predicting recurrent abortion in RSA patients using combined serum miR-184 and miR-513c-5p expression was 0.901, higher than that using either serum miR-184 or miR-513c-5p alone (Z＝3.892, 3.411, P＜0.05). This predictive scheme showed good clinical utility for prediction and intervention. The risk of recurrent abortion in RSA patients with high post-pregnancy serum miR-184 expression was 7.407 times higher, and with high serum miR-513c-5p expression was 18.125 times higher than in patients with low expression (P＜0.05). Conclusion High expression of serum miR-184 and miR-513c-5p is related to RSA and its subsequent pregnancy outcomes. Combined detection of these markers can provide a reference for predicting subsequent pregnancy outcomes, guiding further decision-making and treatment.

关键词

miR-184 / miR-513c-5p / 复发性流产 / 相关性 / 临床意义

Key words

miR-184 / miR-513c-5p / recurrent spontaneous abortion / correlation / clinical significance

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