缺血性心力衰竭患者外周血miR-19a水平与BNP及心功能的关系
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摘要
目的:探究缺血性心力衰竭患者外周血miR-19a水平与B型尿钠肽(Brain natriuretic peptide,BNP)及心功能的关系。方法:将宜城市人民医院100例缺血性心力衰竭患者依据心功能NYHA分级,分为Ⅱ级35例、Ⅲ级42例,Ⅳ级23例。另选取同期进行体检的50例健康者作为对照组,超声心动图检测左室射血分数(LVEF)、左室前后径(LAD)、左室舒张末期内径(LVEDD),采用电化学发光免疫法测定血清BNP水平,实时荧光定量PCR(qRT-PCR)检测外周血miR-19a表达,Pearson相关性分析miR-19a、BNP与LVEF、LAD、LVEDD相关性,受试者工作特征曲线(ROC)评估miR-19a、BNP对缺血性心力衰竭患者心功能分级的预测价值。结果:缺血性心力衰竭组谷丙转氨酶、谷草转氨酶、肌酐、尿素氮、尿酸、血糖显著高于对照组,血红蛋白、总胆固醇显著低于对照组(P<0.05)。随着NYHA分级的升高,患者LAD、LVEDD逐渐升高,LVEF逐渐降低;血清BNP、miR-19a表达逐渐升高(P<0.05)。BNP与LAD、LVEDD呈显著性正相关(r=0.382,r=0.358,P均<0.000),与LVEF呈显著性负相关(r=-0.402,P<0.000)。miR-19a与LAD、LVEDD呈显著性正相关(r=0.415,r=0.336,P均<0.000),与LVEF呈显著性负相关(r=-0.392,P<0.000)。BNP对缺血性心衰患者心功能Ⅲ级的预测的AUC值为0.753,对心功能IV级预测的AUC值为0.704。miR-19a对缺血性心衰患者心功能Ⅲ级的预测的AUC值为0.838,对心功能IV级预测的AUC值为0.795。结论:缺血性心力衰竭患者外周血miR-19a、BNP水平均升高,与患者心功能参数呈正相关,可作为心功能分级的预测因子。
Objective: To investigate the relationships between the level of miR-19a in peripheral blood with brain natriuretic peptide(BNP) and heart function of patients with ischemic heart failure. Methods: According to the NYHA classification of heart function, 100 patients with ischemic heart failure were divided into 35 cases of grade II, 42 cases of grade III, 23 cases of grade IV, another 50 healthy persons in the same period were selected as control group. Left ventricular ejection fraction(LVEF), left ventricular anteroposterior diameter(LAD) and left ventricular end-diastolic diameter(LVEDD) were measured by echocardiogram, the serum BNP level was measured by electrochemiluminescence immunoassay, real time fluorescence quantitative PCR(qRT-PCR) was used to detect the expression of miR-19a in peripheral blood, Pearson correlation analyzed the correlations between miR-19a, BNP with LVEF, LAD, LVEDD, receiver operating characteristic curve(ROC) was used to assess the predictive values of miR-19a and BNP for cardiac function classification in patients with ischemic heart failure. Results: Alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen, uric acid and blood glucose in the ischemic heart failure group were significantly higher than those in the control group, while hemoglobin and total cholesterol were significantly lower than those in the control group(P<0.05). With the increase of NYHA grade, LAD and LVEDD gradually increased, LVEF gradually decreased, BNP and miR-19a expressions gradually increased(P<0.05). BNP was positively correlated with LAD and LVEDD(r = 0.382, r = 0.358, P<0.000) and negatively correlated with LVEF(r =-0.402, P<0.000). MiR-19a was positively correlated with LAD and LVEDD(r = 0.415, r = 0.336, P<0.000), and negatively correlated with LVEF(r =-0.392, P<0.000). The AUC value of BNP for predicting grade III of heart function was 0.753, and the AUC value of BNP for predicting grade IV of heart function was 0.704. The AUC value of miR-19a for predicting grade III of heart function was 0.838, and the AUC value of miR-19a for predicting grade IV of heart function was 0.795. Conclusion: MiR-19a and BNP levels in peripheral blood of patients with ischemic heart failure are increased, which are positively correlated with cardiac function parameters and con be used as predictors of cardiac function classification.
Objective: To investigate the relationships between the level of miR-19a in peripheral blood with brain natriuretic peptide(BNP) and heart function of patients with ischemic heart failure. Methods: According to the NYHA classification of heart function, 100 patients with ischemic heart failure were divided into 35 cases of grade II, 42 cases of grade III, 23 cases of grade IV, another 50 healthy persons in the same period were selected as control group. Left ventricular ejection fraction(LVEF), left ventricular anteroposterior diameter(LAD) and left ventricular end-diastolic diameter(LVEDD) were measured by echocardiogram, the serum BNP level was measured by electrochemiluminescence immunoassay, real time fluorescence quantitative PCR(qRT-PCR) was used to detect the expression of miR-19a in peripheral blood, Pearson correlation analyzed the correlations between miR-19a, BNP with LVEF, LAD, LVEDD, receiver operating characteristic curve(ROC) was used to assess the predictive values of miR-19a and BNP for cardiac function classification in patients with ischemic heart failure. Results: Alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen, uric acid and blood glucose in the ischemic heart failure group were significantly higher than those in the control group, while hemoglobin and total cholesterol were significantly lower than those in the control group(P<0.05). With the increase of NYHA grade, LAD and LVEDD gradually increased, LVEF gradually decreased, BNP and miR-19a expressions gradually increased(P<0.05). BNP was positively correlated with LAD and LVEDD(r = 0.382, r = 0.358, P<0.000) and negatively correlated with LVEF(r =-0.402, P<0.000). MiR-19a was positively correlated with LAD and LVEDD(r = 0.415, r = 0.336, P<0.000), and negatively correlated with LVEF(r =-0.392, P<0.000). The AUC value of BNP for predicting grade III of heart function was 0.753, and the AUC value of BNP for predicting grade IV of heart function was 0.704. The AUC value of miR-19a for predicting grade III of heart function was 0.838, and the AUC value of miR-19a for predicting grade IV of heart function was 0.795. Conclusion: MiR-19a and BNP levels in peripheral blood of patients with ischemic heart failure are increased, which are positively correlated with cardiac function parameters and con be used as predictors of cardiac function classification.
引文
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[2] 李俊梅,王雪梅.急性心力衰竭患者血清激活素A和B型钠尿肽水平变化及意义[J].山东医药,2017,57(6):68～69.
[3] 周浩斌,安冬琪,詹琼,等.不同射血分数心力衰竭患者临床特征和预后的回顾性分析[J].中华内科杂志,2017,56(4):253～257.
[4] 马少卫,于波,马淑梅.心脏再同步化治疗不同起搏模式对终末期心力衰竭心室复极的影响[J].临床误诊误治,2016,29(1):84～88.
[5] 陈骅,刘昕.重组人脑利钠肽对急性前壁心梗急诊经皮冠状动脉介入术后心室重塑和心功能的影响[J].中国医药导报,2018,15(2):126～128.
[6] 王霖.慢性心力衰竭患者血浆脑钠肽水平与心功能相关性临床研究[J].国际检验医学杂志,2015(17):2557～2558.
[7] 李广栋.慢性心力衰竭患者血清CA125及BNP水平与心功能的相关性分析[J].中国医师杂志,2016,18(s1):170～172.
[8] Chistiakov D A,Orekhov A N,Bobryshev Y V.Cardiac-specific miRNA in cardiogenesis,heart function,and cardiac pathology (with focus on myocardial infarction)[J].Journal of Molecular & Cellular Cardiology,2016,94(5):107～121.
[9] Christopher A F,Gupta M,Bansal P.Micronome revealed miR-19a/b as key regulator of SOCS3 during cancer related inflammation of oral squamous cell carcinoma[J].Gene,2016,594(1):30～40.
[10] 郭观华,黄自明,陈丽萍.促血管生成microRNA在冠状动脉疾病诊断中的作用及其与疾病严重程度的关系[J].中国医科大学学报,2018,47(3):268～274.
[11] Miao Y,Chen H,Li M.miR-19a overexpression contributes to heart failure through targeting ADRB1[J].International Journal of Clinical & Experimental Medicine,2015,8(1):642～648.