急性心力衰竭患者血清microRNA-1水平及与心功能和预后的关系

Serum miR-1 level in patients with acute heart failure and its relationship with cardiac function and prognosis

目的探讨急性心力衰竭患者血清microRNA-1(miR-1)水平及其与心功能和预后的关系。方法选取2015年1月—2018年12月在台州市中心医院就诊的急性心力衰竭患者120例作为心力衰竭组,同期健康体检者120例作为对照组。逆转录聚合酶链反应(RT-PCR)测定血清miR-1相对表达量;采用彩色多普勒心脏超声诊断仪测定患者左心房内径(LAD)、左心室舒张末期内径(LVEd),计算左心室射血分数(LVEF)。结果心力衰竭组血清miR-1和LVEF低于对照组(P<0.05);而LAD、LVEd高于对照组(P<0.05)。不同严重程度分级的心力衰竭患者血清miR-1比较,差异有统计学意义(P<0.05),随着心力衰竭严重程度增加,其血清miR-1降低。预后不良组血清miR-1低于预后良好组(P<0.05)。心力衰竭患者血清miR-1与LVEF呈正相关(r=0.578,P<0.05);与LAD、LVEd呈负相关(r=-0.442和-0.473,P<0.05)。心力衰竭患者预后影响因素Logistic回归分析结果显示,miR-1[OR=4.152(95%CI:1.846,5.384)]、LVEF[OR=2.971(95%CI:1.764,4.037)]、LAD[OR=0.706(95%CI:0.415,0.923)]及LVEd[OR=0.721(95%CI:0.427,0.928)]为心力衰竭预后的影响因素。结论心力衰竭患者血清miR-1水平降低,其与心功能和预后关系密切,是心力衰竭不良预后的独立影响因素。

Objective To investigate the serum level of miR-1 in patients with acute heart failure and its relationship with cardiac function and prognosis.Methods Totally 120 patients with acute heart failure were selected as the heart failure group,and 120 healthy patients were selected as the control group(group C)from January 2015 to December 2018.The serum miR-1 level was determined by reverse transcription-polymerase chain reaction(RTPCR).Color doppler echocardiography was used to determine the left atrium diameter(LAD),left ventricular enddiastolic diameter(LVEd)of patients and the left ventricular ejection fraction(LVEF)were calculated.Results The serum miR-1 level and LVEF relative level in the heart failure group were lower than those in the C group(P<0.05),and LAD level and LVEd level were higher than those in the C group(P<0.05).Comparison of serum miR-1 levels in patients with different severity heart failure,and the differences were statistically significant(P<0.05),the serum miR-1 levels decreased with the improvement of heart failure severity.The serum miR-1 levels in the poor prognosis group were lower than those in the good prognosis group(P<0.05).The serum miR-1 levels in patients with heart failure were positively correlated with LVEF(r=0.578,P<0.05),and negatively correlated with LAD(r=-0.442)and LVEd(r=-0.473)(P<0.05).Logistic regression analysis of prognostic influencing factors in patients with heart failure showed that miR-1 level[OR=4.152(95%CI:1.846,5.384)],LVEF[OR=2.971(95%CI:1.764,4.037)],LAD[OR=0.706(95%CI:0.415,0.923)]and LVEd(OR=0.721(95%CI:0.427,0.928)]were all independent influencing factors of prognosis in heart failure.Conclusions The level of serum miR-1 in patients with heart failure is reduced,and its level is closely related to cardiac function and prognosis,which is an independent factor affecting the poor prognosis of heart failure.