老年慢性心力衰竭患者血浆微小RNA-137和微小RNA-150表达与心室重构的相关性

Relationship between miR-137and miR-150expressions and ventricular remodeling in elderly CHF patients

目的探讨老年慢性心力衰竭(CHF)患者血浆微小RNA-137(miR-137)、微小RNA-150(miR-150)表达水平与心室重构之间的关系。方法选择2018年3月~2019年12月本院收治的老年CHF患者107例为研究组,同期选择年龄和性别与研究组相匹配的健康体检者40例为对照组。用荧光定量PCR检测血浆miR-137和miR-150相对表达量;用多普勒超声心动图检测各项心功能指标;用Pearson相关分析,采用ROC曲线评价血浆miR-137和miR-150诊断CHF的价值。结果研究组血浆miR-137和miR-150相对表达量均显著低于对照组(P<0.01);研究组左心室舒张末期内径(LVEDD)明显高于对照组(P<0.05),LVEF、左心室短轴缩短率(LVFS)、二尖瓣口舒张早期与舒张晚期最大血流速度比值(E/A)明显低于对照组(P<0.05)。血浆miR-137和miR-150与LVEDD均呈负相关(r=-0.603,P=0.003;r=-0.534,P=0.010),与LVEF、LVFS和E/A均呈正相关(r=0.637、0.529、0.761,P=0.001、0.011、0.000;r=0.714、0.576、0.717,P=0.000,0.006,0.000);血浆miR-137和miR-150诊断CHF的曲线下面积(AUC)分别为0.749和0.800,界值分别为0.94和0.83,敏感性分别为81.31%和83.18%,特异性分别为62.50%和75.00%;两者联合诊断CHF的AUC为0.843,敏感性为85.95%,特异性为72.50%。结论血浆miR-137和miR-150可能参与老年CHF患者的心肌重构,且与心肌损伤严重程度有关。

Objective To study the relationship between miR-137and miR-150expressions and ventricular remodeling in elderly CHF patients.Methods One hundred and seven elderly CHF patients admitted to our hospital from March 2018to December 2019served as a study group with 40healthy age-and gender-matched persons served as a control group.The miR-137and miR-150 expressions in two groups were detected by fluorescence qPCR.The cardiac function parameters in two groups were detected by Doppler echocardiography.The relationship between miR-137and miR-150expressions and ventricular remodeling was analyzed by Pearson correlation analysis.The value of serum miR-137and miR-150levels in diagnosis of CHF was analyzed by ROC curve analysis.Results The miR-137and miR-150expression levels were significantly lower while the LVEDD was significantly longer in study group than in control group(P<0.01).The LVEF,LVFS,maximum E/A ratio of early and late diastolic mitral valve were significantly lower while the LVEDD was significantly longer in study group than in control group(P<0.05).The serum miR-137and miR-150levels were negatively related with the LVEDD(r=0.603,P=0.003;r=0.534,P=0.010)and positively related with the LVEF,LVFS and E/A(r=0.637,0.529,0.761,P=0.001,0.011,0.000;r=0.714,0.576,0.717,P=0.000,0.006,0.000).ROC curve analysis showed that the AUC for serum miR-137and miR-150levels in diagnosis of CHF was 0.749and 0.800re-spectively,with a cutoff value of 0.94and 0.83respectively,a sensitivity of 81.31%and 83.18%respectively,a specificity of 62.50%and 75.00%respectively,and the AUC for their combination in diagnosis of CHF was 0.843with a sensitivity of 85.95%and a specificity of 72.50%.Conclusion The serum miR-137and miR-150levels may be involved in ventricular remodeling and are related with the severity of myocardial injury in elderly CHF patients.