慢性心衰合并肺部感染患者血清microRNA-21的表达水平及意义

Expression of serum microRNA-21 in chronic heart failure patients complicated with pulmonary infection and its significance

目的探讨慢性心衰合并肺部感染(CHF with pulmonary infection,CHF-PI)患者血清microRNA-21的表达水平及意义。方法选取2016年7月-2018年7月广东省第二人民医院心血管内科收治的CHF患者120例。根据是否发生肺部感染,分为感染组(n=48)和未感染组(n=72),另外选取在广东省第二人民医院进行健康检查的健康人50名作为对照组。采用酶偶联法检测血清心肌酶谱[谷草转氨酶(aspartate a minotransferase AST)、乳酸脱氢酶(lactate dehydrogenase, LDH)、肌酸激酶(creatine kinase, CK)、肌酸激酶同工酶(creatine kinase isoenzyme, CKMB)];化学发光法检测N端脑钠肽原(N-terminal pro-brain natriuretic peptide, NT-proBN)和C-反应蛋白(C-reactive protein, CRP);实时荧光定量逆转录-聚合酶链反应(RT-PCR)法检测microRNA-21和蛋白酪氨酸磷酸酶基因(protein tyrosine phosphatase gene, PTEN)mRNA的相对表达量。相关性检验采用Pearson分析。结果感染组和未感染组microRNA-21和PTEN mRNA水平均高于对照组,且感染组高于未感染组(P<0.05)。感染组和未感染组AST、LDH、CK和CKMB均高于对照组,且感染组高于未感染组(P<0.05)。感染组和未感染组NT-proNP和CRP水平均高于对照组,且感染组高于未感染组(P<0.05)。NYHAⅢ+Ⅳ级CHF-PI患者microRNA-21和PTEN mRNA水平高于NYHAⅠ+Ⅱ级CHF-PI患者(P<0.05)。microRNA-21和PTEN mRNA水平均与AST、LDH、CK、CKMB、NT-proNP、CRP水平呈正相关(P<0.05)。结论 microRNA-21可能通过调控PTEN参与CHF-PI的发病,该通路的过表达与CHF-PI病情严重程度有关。

OBJECTIVE To explore the expression of serum microRNA-21 in the chronic heart failure(CHF) patients complicated with pulmonary infection and analyze its significance. METHODS A total of 120 CHF patients who were treated in department of cardiovascular medicine of the Guangdong Second Provincial General Hospital from Jul 2016 to Jul 2018 were enrolled in the study and divided into the infection group with 48 cases and the non-infection group with 72 cases;50 healthy people who received physical examination in the Guangdong Second Provincial General Hospital were assigned as the control group.The aspartate a minotransferase(AST), lactate dehydrogenase(LDH), creatine kinase(CK) and creatine kinase isoenzyme(CKMB) were detected by using enzyme coupling method;the N-terminal pro-brain natriuretic peptide(NT-proBN) and C-reactive protein(CRP) were detected by chemiluminescence method;the relative expression of microRNA-21 and protein tyrosine phosphatase gene(PTEN) mRNA were detected by means of real-time fluorescence quantitative reverse transcription-polymerase chain reaction(RT-PCR).Pearson analysis was performed for related tests. RESULTS The levels of microRNA-21 and PTEN mRNA of the infection group and the non-infection group were significantly higher than those of the control group, and the levels of the above indexes of the infection group were significantly higher than those of the non-infection group(P<0.05).The levels of AST, LDH, CK and CKMB of the infection group and the non-infection group were significantly higher than those of the control group, and the levels of the above indexes of the infection group were significantly higher than those of the non-infection group(P<0.05).The levels of NT-proNP and CRP of the infection group and the non-infection group were higher than those of the control group, and the levels of the above indexes of the infection group were significantly higher than those of the non-infection group(P<0.05).The levels of microRNA-21 and PTEN mRNA of the patients with NYHAⅢ plus Ⅳ grade of CHF-PI were significantly higher than those of the patients with NYHAⅠplus Ⅱ grade of CHF-PI(P<0.05).The levels of microRNA-21 and PTEN mRNA were positively correlated with the levels of AST, LDH, CK, CKMB, NT-proNP and CRP(P<0.05). CONCLUSION MicroRNA-21 may be involved in the pathogenesis of CHF-PI by regulating PTEN.The overexpression of this pathway is associated with the severity of CHF-PI.