| 肖欢,张志安,梅军华,等.母体血清微 RNA-146a-5p联合三联法检测在孕中期唐氏综合征筛查中的意义[J].安徽医药,2023,27(6):1231-1234. |
| 母体血清微 RNA-146a-5p联合三联法检测在孕中期唐氏综合征筛查中的意义 |
| Significance of maternal serum miR-146a-5p combined with triple assay in screening for Down's syndrome in the midtrimester |
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| DOI：10.3969/j.issn.1009-6469.2023.06.040 |
| 中文关键词: 唐氏综合征 微 RNA-146a-5p 新生儿筛查 妊娠中期 甲胎蛋白类 绒毛膜促性腺激素， β亚单位，人 雌三醇 |
| 英文关键词: Down′s syndrome miR-146a-5p Neonatal screening Midtrimester Alpha-fetoprotein class Chorionic gonadotropin,beta subunit, human Estriol |
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| 中文摘要: |
| 目的探讨母体血清微 RNA-146a-5p(miR-146a-5p)联合三联法检测在孕中期唐氏综合征筛查中的意义。方法选取 2017年 1月至 2020年 8月于黄冈市中心医院孕中期行唐氏综合征筛查结果为阳性的孕妇 65例(病例组)同期选择本院健康的妊娠孕妇 65例(对照组)。使用化学发光免疫分析仪检测孕妇血清甲胎蛋白( AFP)人绒毛膜促性腺激素(，β-hCG)以及游离雌三醇( uE3)指标。实时荧光定量 PCR法检测血清中 miR-146a-5p的水平。采用受试者，操作特征( ROC)曲线分析母体血清 miR-146a-5p联合三联法对孕中期唐氏综合征的预测价值。采用 Pearson法分析 miR-146a-5p相对表达水平与血清 AFP、uE3β -hCG中位数的倍数( MOM)值的相关性。结果与对照组( 1.89±0.32)U/mL、(1.63±0.36)μg/L、1.03±0.24、(2.41±0.28)μg/L相、比，病例组孕妇血清 AFP MOM值( 2.84±0.27)U/mL、β-hCG MOM值( 2.84±0.25)μg/L及血清 miR-146a-5p相对表达水平 3.07±0.95较高(P<0.05)uE3 MOM值( 1.71±0.19)μg/L较低( P<0.05)。 Pearson法分析显示， miR-146a-5p与 AFP、β-hCG呈正相关( P<0.05)与uE3呈负(P<0.05)。 ROC曲线结果显示， AFP+uE3+β-hCG预测孕中期唐氏综合征的曲线下面积( AUC)为 0.85，灵敏度为 83.10%，特异度分别为 75.40%；miR-146a-5p预测孕中期唐氏综合征的 AUC为 0.86，灵敏度为 81.50%，特异度为相关，分别，87.70%；miR-146a-5p+AFP+uE3+β-hCG预测子孕中期唐氏综合征的 AUC为 0.91，灵敏度为 86.20%，特异度为 80.00%，miR146a-5p联合三联法检测对孕中期唐氏综合征筛查价值高于三联法检测( P<0.05)。结论母体血清 miR-146a-5p联合三联法对孕中期唐氏综合征的预测效能具有较高的临床价值，可为孕中期唐氏综合征筛查提供一种新途径。 |
| 英文摘要: |
| Objective To explore the significance of maternal serum microRNA-146a-5p (miR-146a-5p) combined with a triple assay in screening for Down′s syndrome in the midtrimester.Methods A total of 65 pregnant women who had positive results of Down′ssyndrome screening performed in the midtrimester at Huanggang Central Hospital from January 2017 to August 2020 were selected(case group), and 65 healthy pregnant women from the hospital during the same period were selected (control group). A chemiluminescence immunoassay analyzer was used to detect serum alpha-fetoprotein (AFP), β-human chorionic gonadotropin (β-hCG) and free estriol (uE3) indicators in pregnant women. A real-time fluorescent quantitative PCR assay was performed to detect the serum miR-146a5p levels. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of maternal serum miR-146a-5pcombined with the triple assay for Down′s syndrome in the midtrimester. The Pearson method was used to analyze the correlation between the relative expression levels of miR-146a-5p and the serum AFP, uE3, and β-hCG multiple of the median (MOM) values.Re? sults Compared with the control group (1.89±0.32) U/mL, (1.63±0.36) μg/L, 1.03±0.24 and (2.41±0.28) μg/L, the serum AFP MOM(2.84±0.27) U/mL, β-hCG MOM values (2.84±0.25) μg/L and the relative serum miR-146a-5p level 3.07±0.95 were higher in pregnant women in the case group (P<0.05), and the uE3 MOM value (1.71±0.19) μg/L was lower (P<0.05). Pearson analysis showed that miR146a-5p was positively correlated with AFP and β-hCG (P<0.05) and negatively correlated with uE3 (P<0.05). The ROC curve results showed that the area under the curve (AUC) of AFP+uE3+β-hCG for predicting Down′s syndrome in the midtrimester was 0.85, with asensitivity of 83.10% and a specificity of 75.40%; the AUC of miR-146a-5p for predicting Down′s syndrome in the midtrimester was0.86, with a sensitivity of 81.50% and a specificity of 87.70%. The AUC of miR-146a-5p+AFP+uE3+β-hCG for predicting Down′s syndrome in midtrimester was 0.91, with a sensitivity of 86.20% and a specificity of 80.00%. The value of miR-146a-5p combined with the triple assay was higher than that of the triple assay for screening Down′s syndrome in midtrimester (P<0.05).Conclusion The maternal serum miR-146a-5p combined with triple assay has high clinical value in predicting the efficacy of Down′s syndrome in the midtrimester and may provide a new way of screening for Down′s syndrome in the midtrimester. |
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