血清miR-22、HSPB1水平与急性Stanford A型主动脉夹层患者预后的关系

Relationship between serum microRNA-22 and HSPB1 levels and prognosis of patients with acute Stanford type A aortic dissection

目的探讨血清微小RNA-22(miR-22)、热休克蛋白家族B(小)成员1(HSPB1)水平与急性Stanford A型主动脉夹层(ATAAD)患者预后的关系。方法选取2020年1月~2022年5月乐山市人民医院收治的145例ATAAD患者(ATAAD组),根据院内存活状况分为死亡组22例和存活组123例,另选取同期52名体检健康者(对照组)。收集ATAAD患者临床资料,采用qPCR和酶联免疫吸附法检测血清miR-22、HSPB1水平。通过多因素Logistic回归分析ATAAD患者死亡的影响因素,ROC曲线分析血清miR-22、HSPB1水平对ATAAD患者死亡的预测价值。结果ATAAD组的血清miR-22水平低于对照组,HSPB1水平高于对照组(P<0.05)。多因素Logistic回归分析显示,年龄增加(OR=1.077,95%CI:1.001~1.158)、心肌梗死(OR=2.963,95%CI:1.156~7.597)、休克(OR=3.178,95%CI:1.209~8.359)、心包积液(OR=2.684,95%CI:1.067~6.751)、HSPB1升高(OR=1.256,95%CI:1.013~1.557)为ATAAD患者死亡的独立危险因素,miR-22升高(OR=0.417,95%CI:0.196~0.888)为独立保护因素(P<0.05)。ROC曲线分析显示,血清miR-22、HSPB1水平单独与联合预测ATAAD患者死亡的曲线下面积分别为0.792、0.782、0.873,敏感度分别为81.82%、59.09%、86.36%,特异度分别为73.98%、88.62%、76.42%。结论血清miR-22水平降低和HSPB1水平升高与ATAAD患者预后不良独立相关,可作为ATAAD患者预后不良的辅助预测指标。

Objective To investigate the relationship between serum microRNA-22(miR-22)and heat shock protein family B(small)member 1(HSPB1)levels and the prognosis of patients with acute Stanford type A aortic dissection(ATAAD).Methods A total of 145 patients with ATAAD admitted to our hospital from January 2020 to May 2022(ATAAD group)were selected and divided into either a death group(22 cases)or a survival group(123 cases)according to their in-hospital survival status,and another 52 healthy individuals who underwent physical examination during the same period were selected as a control group.Clinical data of ATAAD patients were collected and serum miR-22 and HSPB1 levels were measured by qPCR and enzyme-linked immunosorbent assay.Multi-factor logistic regression was used to analyze the factors influencing death in ATAAD patients,and ROC curve analysis was performed to assess the predictive value of serum miR-22 and HSPB1 levels for death in ATAAD patients.Results Serum miR-22 levels were lower in the ATAAD group than in the control group,and HSPB1 levels were higher than those in the control group(P<0.05).Multifactorial logistic regression analysis showed that increased age(OR=1.077,95%CI:1.001 to 1.158),myocardial infarction(OR=2.963,95%CI:1.156 to 7.597),shock(OR=3.178,95%CI:1.209 to 8.359),pericardial effusion(OR=2.684,95%CI:1.067 to 6.751),and elevated HSPB1(OR=1.256,95%CI:1.013 to 1.557)were independent risk factors for death in ATAAD patients,and elevated miR-22(OR=0.417,95%CI:0.196 to 0.888)was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve values of serum miR-22 and HSPB1 levels alone and in combination for predicting death in ATAAD patients were 0.792,0.782,and 0.873,respectively,with sensitivities of 81.82%,59.09%,and 86.36%and specificities of 73.98%,88.62%,and 76.42%,respectively.Conclusion Decreased serum miR-22 levels and increased HSPB1 levels are independently associated with a poor prognosis in ATAAD patients and can be used as an auxiliary predictor of poor prognosis in ATAAD patients.