广西医学

目的探讨妊娠期高血压（GH）患者血清miR-34a-5p、miR-488-3p表达水平及其与疾病严重程度、不良妊娠结局的关系。方法纳入82例GH患者（GH组）及82例正常妊娠女性，并根据疾病严重程度将GH组患者分为单纯GH组37例、轻度子痫前期组（轻度PE组）28例、重度子痫前期组（重度PE组）17例，又根据妊娠结局将GH组患者分为妊娠结局良好组（良好组）37例和妊娠结局不良组（不良组）45例。比较GH组和对照组患者的临床指标。采用实时荧光定量PCR法检测所有孕妇的血清miR-34a-5p、miR-488-3p表达水平，分析血清miR-34a-5p、miR-488-3p表达水平与GH疾病严重程度及妊娠结局的关系。采用受试者工作特征曲线分析血清miR-34a-5p、miR-488-3p表达水平单独及联合预测GH患者不良妊娠结局的价值。结果相较于对照组，GH组平均动脉压、舒张压、收缩压、24 h尿蛋白含量，以及血清miR-34a-5p、miR-488-3表达水平升高（P＜0.05）。单纯GH组、轻度PE组、重度PE组患者血清miR-34a-5p、miR-488-3p表达水平依次升高（P＜0.05）。良好组患者血清miR-34a-5p、miR-488-3p表达水平低于不良组（P＜0.05）。血清miR-34a-5p、miR-488-3p表达水平单独及联合预测GH患者不良妊娠结局的曲线下面积分别为0.860、0.808、0.911，联合预测的曲线下面积优于单一指标预测的曲线下面积（P＜0.05）。结论 GH患者血清miR-34a-5p、miR-488-3p表达水平升高，二者对GH患者不良妊娠结局均具有较好的预测效能，且联合预测效能更佳。

ObjectiveTo investigate the expressions of serum miR-34a-5p and miR-488-3p in patients with gestational hypertension (GH), and their relation with severity and adverse pregnancy outcome. MethodsA total of 82 GH patients (the GH group) and 82 normal pregnant women were enrolled, and they were assigned to simple GH group (37 cases), mild preeclampsia group (the mild PE group, 28 cases), or severe preeclampsia group (the severe PE group, 17 cases) according to severity, and then patients in the GH group were further assigned to favorable pregnancy outcome group (the favorable group, 37 cases) or adverse pregnancy outcome group (the adverse group, 45 cases) according to pregnancy outcomes. The clinical indices were compared between patients of the GH group and the control group. The real-time fluorescent quantitative PCR was applied to detect expressions of serum miR-34a-5p and miR-488-3p, and to analyze the relation of serum miR-34a-5p and miR-488-3p expressions with GH severity and pregnancy outcomes. The receiver operating characteristic curve was employed to analyze values of serum miR-34a-5p and miR-488-3p expressions for alone and jointly predicting adverse pregnancy outcome in GH patients. ResultsCompared with the control group, the GH group exhibited elevated mean arterial pressure, diastolic blood pressure, systolic blood pressure, and 24-hour urinary protein content, as well as elevated expressions of serum miR-34a-5p and miR-488-3p (P＜0.05). Serum miR-34a-5p and miR-488-3p expressions were elevated successively in the simple GH group, the mild PE group, and the severe PE group (P＜0.05). Serum miR-34a-5p and miR-488-3p expressions in patients of the favorable group were lower than those of the adverse group (P＜0.05). Areas under the curve of serum miR-34a-5p and miR-488-3p expressions for alone and jointly predicting adverse pregnancy outcome in GH patients were 0.860, 0.808, and 0.911, respectively, and area under the curve of the combined prediction was superior to that of prediction of single index (P＜0.05). ConclusionSerum miR-34a-5p and miR-488-3p expressions are elevated in GH patients. The two all exert favorable predictive efficiency on adverse pregnancy outcome in GH patients, and the combined prediction exerts superior efficiency.