循环miRNA-208a在射血分数降低性心力衰竭的诊断价值研究

doi:10.3969/j.issn.1006-6233.2023.10.022

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摘要 目的:探讨循环miRNA-208a的表达水平在射血分数降低性心力衰竭(HFrEF)诊断中的临床价值。方法:选取2021年1月至2022年12月我院心血管内科收治的120例心力衰竭(HF)患者,其中HFrEF患者56例纳入HFrEF组,非HFrEF患者64例纳入非HFrEF组,另选取同期健康体检者60例为对照组,超声心动图测定左室射血分数(LVEF)、左心室缩短分数(LVFS)、左心房直径(LAD)、左心室质量指数(LVMI),实时荧光定量PCR检测miRNA-208a、β-肌球蛋白重链(β-MHC)mRNA表达量,电化学发光法测定血清氨基末端脑钠肽前体(NT-proBNP)水平。结果:HFrEF组和非HFrEF组LVEF、LVFS均明显低于对照组,而LAD、LVMI均明显高于对照组(P<0.05);HFrEF组LVEF、LVFS均明显低于非HFrEF组,LAD、LVMI均明显高于非HFrEF组,差异有统计学意义(P<0.05)。HFrEF组和非HFrEF组血清NT-proBNP及miRNA-208a、β-MHC mRNA表达量均明显高于对照组,HFrEF组血清NT-proBNP及miRNA-208a、β-MHC mRNA表达量均明显高于非HFrEF组,差异有统计学意义(P<0.05)。三组miRNA-208a表达量与LVEF、LVFS呈负相关,与LAD、LVMI、NT-proBNP及β-MHC mRNA呈正相关,差异均有统计学意义(P<0.05)。miRNA-208a诊断HFrEF的曲线下面积(AUC)为0.757,最佳截断值为5.19,约登指数为0.417,敏感度为89.29,特异度为52.42%。血清NT-proBNP、miRNA-208a及β-MHC mRNA三者联合诊断的AUC为0.996,最佳截断值为0.592,约登指数为0.956,敏感度为96.43%,特异度为99.19%。结论:miRNA-208a在HFrEF患者循环血中的表达量明显上升,可作为诊断HFrEF的生物学标志物,且与NT-proBNP、β-MHC mRNA联合应用诊断效能更佳。

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	龚倩
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关键词 ： miRNA-208a, 射血分数, 心力衰竭, 诊断价值

Abstract：Objective: To investigate the clinical value of circulating miRNA-208a expression levels in the diagnosis of heart failure with reduced ejection fraction (HFrEF). Methods: From January 2021 to December 2022, 120 patients with heart failure (HF) admitted to the Department of Cardiovascular Medicine of our hospital were selected. Among them, 56 patients with HFrEF were included in the HFrEF group, 64 patients with non-HFrEF were included in the non-HFrEF group, and 60 healthy people in the same period were selected as the control group. Left ventricular ejection fraction (LVEF), left ventricular shortening fraction (LVFS), left atrial diameter (LAD), and left ventricular mass index (LVMI) were measured by echocardiography, Detection of miRNA-208a β- Myosin heavy chain( β- MHC) mRNA expression, and the serum level of N-terminal pro-brain natriuretic peptide precursor (NT-proBNP) was measured by electrochemiluminescence method. Results: LVEF and LVFS in HFrEF group and non-HFrEF group were significantly lower than those in the control group, while LAD and LVMI were significantly higher than those in the control group (P<0.05); LVEF and LVFS in HFrEF group were significantly lower than those in non-HFrEF group, and LAD and LVMI were significantly higher than those in non-HFrEF group (P<0.05). Serum NT-proBNP and miRNA-208a in HFrEF group and non-HFrEF group β- The expression of MHC mRNA was significantly higher than that of the control group. The serum NT-proBNP and miRNA-208a β- The expression of MHC mRNA was significantly higher than that of non-HFrEF group (P<0.05). The expression of miRNA-208a in three groups was negatively corre- lated with LVEF and LVFS, and with LAD, LVMI, NT-proBNP and β- MHC mRNA was positive- ly correlated and the difference was statistically significant (P<0.05). The area under curve (AUC) of miRNA-208a in diagnosis of HFrEF is 0.757, the best cut-off value is 5.19, the Jordan index is 0.417, the sensitivity is 89.29, and the specificity is 52.42%. The AUC of the combined diagnosis ofSerum NT-proBNP, miRNA-208a and β- MHC mRNA is 0.996, the best cut-off value is 0.592, the Jordan index is 0.956, the sensitivity is 96.43%, and the specificity is 99.19%. Conclusion: The expression of miRNA-208a in the circulating blood of patients with HFrEF is significantly incre- ased, which can be used as a biomarker for diagnosis of HFrEF, and can be compared with NT-proBNP β- The combined application of MHC mRNA has better diagnostic efficacy.

Key words： MiRNA-208a Ejection fraction Heart failure Diagnostic value

基金资助:四川省卫生计生委科研课题计划项目,(编号:18ZD007)

通讯作者: 李郁

引用本文:

龚倩, 黎东, 李郁, 罗彩东. 循环miRNA-208a在射血分数降低性心力衰竭的诊断价值研究[J]. 河北医学, 2023, 29(10): 1698-1704.
GONG Qian, LI Dong, LI Yu, et al. Diagnostic Value of Circulating miRNA-208a in Heart Failure with Reduced Ejection Graction. HeBei Med, 2023, 29(10): 1698-1704.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.10.022 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I10/1698

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