Fan Yang, Qin Huiling, Ma Lei, Bian Li, Zhao Biao, Zeng Wei
People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University.
Department of Rehabilitation Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities.
Tohoku J Exp Med. 2025 May 10;266(1):11-18. doi: 10.1620/tjem.2024.J090. Epub 2024 Sep 12.
The risk of a second caesarean section with scarred uterus has attracted attention, and this study aimed to find a molecular marker to assist physicians in prenatal screening to better predict postpartum complications. Serum miR-192-5p expression was determined by qRT-PCR and 145 subjects were divided into low expression group (76) and high expression group (69) based on the miR-192-5p levels. The Receiver Operating Characteristic curve (ROC) was plotted with pelvic floor dysfunction (PFD) score, vaginal microecological environment status, and the occurrence of serious complications occurred as dependent variables. miR-192-5p expression was the test variable. Significant differences were found between the high and low MiR-192-5p expression groups in postpartum class I, class II muscle fiber strength, PFD score (p < 0.01), postpartum vaginal leukocyte esterase (p < 0.001), sialyl glycosidase (p = 0.010), acetylglucosaminidase (p = 0.024), and severe complications (p = 0.001). The ROC for predicting PFD showed an AUC of 0.861. The ROC for predicting vaginal microecological environment showed an AUC of 0.934. The ROC for predicting serious complications showed an AUC of 0.882. MiR-192-5p has the potential to be an adjunctive preoperative screening marker for cesarean section in patients with scarred uterus and has potential value in predicting the occurrence of complications after cesarean section, including PFD, vaginal microecological disorders, postoperative hemorrhage, abdominal incision infections, puerperal infections.
瘢痕子宫再次剖宫产的风险已引起关注,本研究旨在寻找一种分子标志物,以协助医生进行产前筛查,更好地预测产后并发症。通过qRT-PCR测定血清miR-192-5p表达,并根据miR-192-5p水平将145名受试者分为低表达组(76例)和高表达组(69例)。以盆底功能障碍(PFD)评分、阴道微生态环境状态及严重并发症的发生情况为因变量绘制受试者工作特征曲线(ROC)。miR-192-5p表达为检验变量。结果发现,高、低miR-192-5p表达组在产后Ⅰ类、Ⅱ类肌纤维强度、PFD评分(p<0.01)、产后阴道白细胞酯酶(p<0.001)、唾液酸酶(p=0.010)、乙酰氨基葡萄糖苷酶(p=0.024)及严重并发症(p=0.001)方面存在显著差异。预测PFD的ROC曲线下面积(AUC)为0.861。预测阴道微生态环境的ROC曲线下面积为0.934。预测严重并发症的ROC曲线下面积为0.882。MiR-192-5p有潜力成为瘢痕子宫患者剖宫产术前辅助筛查标志物,在预测剖宫产术后并发症的发生方面具有潜在价值,包括PFD、阴道微生态紊乱、术后出血、腹部切口感染、产褥感染。