范海博

[关键词] 妊娠期肝内胆汁淤积症;血清微小RNA-21;胰岛素样生长因子结合蛋白-3;不良妊娠结局;相关性

[中图分类号] R714          [文献标识码] B          [文章编号] 1673-9701（2021）17-0120-04

Correlation between serum miR-21 and IGFBP-3 levels and adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy

FAN Haibo

Department of Laboratory Medicine， Jiamusi Maternal and Child Health Hospital in Heilongjiang Province， Jiamusi 154002， China

[Abstract] Objective To explore the correlation between serum levels of microRNA-21 （mir-21）， insulin-like growth factor binding protein-3 （IGFBP-3） and adverse pregnancy outcomes of patients with intrahepatic cholestasis of pregnancy （ICP）. Methods A total of 87 patients with ICP who gave birth in our hospital from February 2018 to February 2020 were selected. The pregnancy outcomes of selected parturient were recorded. Low birth weight and premature rupture of membranes were taken as adverse pregnancy outcomes in the adverse pregnancy outcome group （n=51）， and the rest of normal pregnant women were taken into the normal pregnancy outcome group （n=36）. The levels of miR-21 and IGFBP-3 were detected in all parturient. The relationship between serum miR-21， IGFBP-3 levels and adverse pregnancy outcomes of patients with ICP was analyzed. Results The level of miR-21 was higher and the level of IGFBP-3 BP-3 was lower in the adverse pregnancy outcome group than those in the normal pregnancy outcome group （P<0.05）. Logistics regression analyses showed that the regression equation was Y=-0.348-5.368X1+12.865X2， which suggested that the increase of serum miR-21 level and the decrease of IGFBP-3 level were the influencing factors leading to adverse pregnancy outcome （OR>1， P<0.05）. Receiver operating characteristic curve （ROC） was plotted， and the results showed that the area under the curve （AUC） of the combination of serum miR-21 and IGFBP-3 to predict the adverse pregnancy outcome of patients with ICP was 0.976， which had certain predictive value and obtained the best predictive value. Conclusion Serum levels of miR-21 and IGFBP-3 in patients with ICP are closely related to adverse pregnancy outcomes， which can provide timely and effective preventive measures for these patients.

[Key words] Intrahepatic cholestasis of pregnancy; Serum microRNA-21; Insulin-like growth factor binding protein-3; Adverse pregnancy outcome; Correlation

妊娠期肝內胆汁淤积症主要以皮肤瘙痒和胆汁酸升高为主要特征，是造成围生儿死亡的重要影响因素，且对孕产妇健康造成不良威胁[1]。随着现代医疗的迅猛发展，抗胆汁淤积类、皮质激素类药物已被广泛应用于该疾病的治疗中，可有效控制疾病发展，但临床应用中发现，仍有部分孕产妇存在诸多不良妊娠结局，威胁母婴安全，因此，早期明确疾病发展情况，可为临床及时实施有效的预防措施提供依据。相关研究表明，血清微小RNA-21（MicroRNAs-21，miR-21）、胰岛素样生长因子结合蛋白-3（Insulin-like growth factor binding protein-3，IGFBP-3）是该疾病的敏感指标，其中miR-21属于一种微小RNA，参与多种疾病的发生与发展;IGFBP-3主要是由肝脏合成与分泌，其含量在该疾病中变化较为明显[2]。鉴于此，本研究将选取2018年2月至2020年2月在我院进行分娩的87例妊娠期肝内胆汁淤积症患者，旨在探讨miR-21、IGFBP-3水平与妊娠期肝内胆汁淤积症患者不良妊娠结局的相关性，现报道如下。

1 资料与方法

1.1 一般资料

选取2018年2月至2020年2月在我院进行分娩的87例妊娠期肝内胆汁淤积症患者，统计入选产妇妊娠结局，将新生儿低体重、胎膜早破等情况作为不良妊娠结局，共计51例，将其设为不良妊娠结局组（n=51），其余正常妊娠产妇将其设为正常妊娠结局组（n=36）。不良妊娠结局组年龄23～36岁，平均（29.24±4.07）岁;孕龄34～42周，平均（38.20±1.54）周;正常妊娠结局组年龄22～37岁，平均（29.30±4.11）岁;孕龄33～41周，平均（38.19±1.51）周。……