摘要
目的 探讨妊娠期肝病患者外周血25-羟基维生素D_(3)[25-hydroxy vitamin D_(3),25(OH)D_(3)]、高迁移率蛋白1(high mobility group box 1,HMGB1)、微小RNA-122(microRNA-122,miR-122)表达与凝血功能的相关性。方法 选取2019年2月至2021年2月东营区人民医院收治的78例妊娠期肝病患者作为研究组,另选取同期78例健康孕妇作为对照组。比较两组25(OH)D_(3)、HMGB1、miR-122、凝血酶原时间(prothombin time,PT)、活化部分凝血活酶时间(activited partial thomboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、γ-谷氨酰转肽酶(γ-glutamyltranspeptidase,GGT)水平,分析25(OH)D_(3)、HMGB1、miR-122与凝血功能指标的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价25(OH)D_(3)、HMGB1、miR-122与凝血功能指标对妊娠期肝病的评估价值,比较两组患者的妊娠结局。结果 研究组患者25(OH)D_(3)[(54.17±9.47)nmol/Lvs(65.98±11.02)nmol/L]和FIB[(2.74±0.69)g/L vs (5.31±1.49)g/L]水平低于对照组,HMGB1[(8.52±1.93)μg/L vs (6.17±1.59)μg/L]、miR-122 (13.49±4.07vs 8.28±2.50)、PT[(15.84±5.13)s vs (12.69±3.46)s]、APTT[(40.12±7.41)s vs (32.19±8.03)s]、ALT[(22.49±3.56)U/L vs (8.31±2.64)U/L]、AST[(78.29±12.75)U/L vs (21.69±7.28)U/L]、GGT[(42.49±11.16)U/L vs (20.69±6.24)U/L]水平高于对照组,差异有统计学意义(P均<0.05)。妊娠期肝病患者25(OH)D_(3)、FIB与ALT、AST、GGT呈负相关,HMGB1、miR-122、PT、APTT与ALT、AST、GGT呈正相关(P均<0.05)。妊娠期肝病患者25(OH)D_(3)与PT、APTT呈负相关,与FIB呈正相关,HMGB1、miR-122与PT、APTT呈正相关,与FIB呈负相关(P均<0.05)。25(OH)D_(3)、HMGB1、miR-122与凝血功能指标联合评估妊娠期肝病的ROC曲线下面积为0.884;研究组患者不良妊娠结局发生率高于对照组[16.67%(13/78) vs 2.56%(2/78);χ^(2)=8.925,P=0.003]。结论 妊娠期肝病患者外周血25(OH)D_(3)、HMGB1、miR-122水平与凝血功能间存在良好线性关系,对患者外周血25(OH)D_(3)、HMGB1、miR-122水平及凝血功能进行检测在妊娠期肝病评估方面具有一定辅助作用。
Objective To investigate the correlation between the expression of 25-hydroxyvitamin D_(3)[25(OH)D_(3)],high mobility protein 1(HMGB1),microRNA-122(miR-122)and blood coagulation in peripheral blood of patients with liver disease during pregnancy.Methods Total of 78 patients with liver disease during pregnancy in Dongying District People’s Hospital from February 2019 to February 2021 were selected as research group,and 78 healthy pregnant women during the same period were selected as control group.The levels of 25(OH)D_(3),HMGB1,miR-122,prothombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),aspartate aminotransferase(AST),alanine aminotransferase(ALT)andγ-glutamyltranspeptidase(GGT)of patients in two groups were compared.The correlation between 25(OH)D_(3),HMGB1,miR-122 and blood coagulation indexes were analyzed.Receiver operating characteristic(ROC)curve was used to evaluate the value of 25(OH)D_(3),HMGB 1,miR-122 and coagulation function indexes on liver diseases of pregnancy.The pregnancy outcomes of patients between the two groups were compared.Results The levels of 25(OH)D_(3)[(54.17±9.47)nmol/L vs(65.98±11.02)nmol/L]and FIB[(2.74±0.69)g/L vs(5.31±1.49)g/L]of patients in research group were lower than those in control group,the levels of HMGB1[(8.52±1.93)μg/L vs(6.17±1.59)μg/L],miR-122(13.49±4.07 vs 8.28±2.50),PT[(15.84±5.13)s vs(12.69±3.46)s],APTT[(40.12±7.41)s vs(32.19±8.03)s],ALT[(22.49±3.56)U/L vs(8.31±2.64)U/L],AST[(78.29±12.75)U/L vs(21.69±7.28)U/L]and GGT[(42.49±11.16)U/L vs(20.69±6.24)U/L]were higher than those in control group,the differences were statistically significant(all P<0.05).For patients with liver disease during pregnancy,25(OH)D_(3) and FIB were negatively associated with ALT,AST and GGT,respectively,HMGB1,miR-122,PT and APTT were positively associated with ALT,AST and GGT,respectively(all P<0.05);25(OH)D_(3) was positively associated with PT and APTT,and was negatively associated with FIB(all P<0.05).The area under ROC curve of 25(OH)D_(3),HMGB 1,miR-122 combined with coagulation function indexes on liver disease in pregnancy was 0.884.The incidence of adverse pregnancy outcomes of patients in control group was significantly higher than that of research group[16.67%(13/78)vs 2.56%(2/78);χ^(2)=8.925,P=0.003].Conclusions There was a good linear relationship between peripheral blood 25(OH)D_(3),HMGB1,miR-122 levels and coagulation function in patients with liver disease during pregnancy.The peripheral blood 25(OH)D_(3),HMGB1,miR-122 levels and coagulation function had a certain auxiliary role on the evaluation of liver disease during pregnancy.
作者
王青青
商军锋
赵洪星
Wang Qingqing;Shang Junfeng;Zhao Hongxing(Clinical Laboratory,The people’s Hospital of Dongying District,Dongying 257000,Shandong Province,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2023年第4期66-72,共7页
Chinese Journal of Liver Diseases：Electronic Version
作者简介
通讯作者:商军锋,Email:ouemzc5xfl@21cn.com。
