MicroRNA-21在慢性阻塞性肺疾病并发肺动脉高压患者的表达及临床意义

Expression and significance of serum microRNA-21 in patients with chronic obstructive pulmonary disease associated with pulmonary hypertension

目的探讨血清微小RNA-21(miRNA-21)表达在慢性阻塞性肺疾病(COPD)并发肺动脉高压(PH)患者的表达及临床意义。方法 COPD患者70例分为单纯COPD组(A组,40例)和COPD并发PH组(B组,30例);同期健康体检人群作为对照组(C组,30例)。检测血清miRNA-21表达和N-端脑钠肽前体(NT-proBNP)含量,心脏彩超测定肺动脉收缩压。结果 B组血清miRNA-21相对表达量高于A组与C组(P<0.01)。miRNA-21与肺动脉收缩压和NT-proBNP呈正相关(r分别为0.37和0.44,P<0.05)。ROC曲线分析显示,ROC曲线下面积为0.844(95%CI=0.762-0.926);取临界值2.18时,其诊断COPD患者并发PH的灵敏度为76.7%,特异度为80.8%。结论COPD并发PH患者血清中miRNA-21明显升高,可能作为COPD患者并发PH的早期诊断及病情评估的潜在生物标记物。

Objective To investigate the expression and significance of serum microRNA-21 （miRNA-21） in the patients with chronic obstructive pulmonary disease （COPD） associated with pulmonary hypertension （PH）. Methods Serum miRNA-21 and NT-proBNP were measured and pulmonary pressure was measured by Doppler echocardiography in 40 COPD patients（group A）, 30 COPD patients with PH（group B） and 30 healthy people（group C）. Results Serum levels of miRNA-21 and NT-proBNP in group B were significantly higher than those in groups of A and C （P〈0. 01）. Serum level of miRNA-21 was positively correlated with pulmonary pressure and NT-proBNP（r=0. 37 and 0. 44, P〈0. 05）. The area under ROC curve was 0. 844 （95% CI= 0. 762- 0. 926）. Taking 2. 18 as a cutoff value, the sensitivity and specificity for serum miRNA-21 to diagnose COPD associated with PH were 0. 767 and 0. 808, respectively. Conclusion Serum miRNA-21 in COPD patients with PH is increased significantly and may be considered as a potential biomarker for early detection and assessment of PH.