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摘要：
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摘要：目的 探讨妊娠期肝病患者外周血25-羟基维生素D3 [25-hydroxy vitamin D3，
25（OH）D3]、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）D3、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）D3、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）D3、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）D3 [（54.17 ± 9.47）nmol/L vs
（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 ± 4.07
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]、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）D3、
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）D3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）D3、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）D3、
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）
D3、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。
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Abstract: Objective To investigate the correlation between the expression of
25-hydroxyvitamin D3 [25(OH)D3], 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)D3, HMGB1, miR-122, prothombin time (PT), activated partial thromboplastin
time (APTT), fibrinogen (FIB), aspartate aminotransferase (AST), alanine aminotransferase
(ALT) and γ-glutamyltranspeptidase (GGT) of patients in two groups were compared. The
correlation between 25(OH)D3, HMGB1, miR-122 and blood coagulation indexes were
analyzed. Receiver operating characteristic (ROC) curve was used to evaluate the value of
25 (OH) D3, 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)D3 [(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)D3 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)D3 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)D3,
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)D3, HMGB1, miR-122 levels and coagulation function in patients with liver disease
during pregnancy. The peripheral blood 25(OH)D3, HMGB1, miR-122 levels and coagulation
function had a certain auxiliary role on the evaluation of liver disease during pregnancy.
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