血清微小核糖核酸-30a及结缔组织生长因子对慢性心力衰竭患者心室重构及预后的关系

Relationship between serum miR-30a,connective tissue growth factor and ventricular remodeling and prognosis in patients with chronic heart failure

目的:探究血清微小RNA-30a(miR-30a)、结缔组织生长因子(CTGF)的表达水平与慢性心力衰竭(CHF)患者心室重构及预后的关系。方法:选取本院2016年3月至2019年5月,就诊的CHF患者98例为CHF组,并选取同期98例体检正常者为健康组。检测血清miR-30a、CTGF、NT-proBNP水平;Pearson法分析CHF患者血清miR-30a、CTGF水平与NT-proBNP、心功能及心室重构指标及不良预后的相关性;比较两组不同预后CHF患者血清miR-30a、CTGF及基线资料;分析其对CHF患者预后的诊断价值。结果:CHF组患者血清miR-30a、CTGF、NT-proBNP水平及LVEDD、右心室内径(RVD)、左心室质量指数(LVMI)均明显高于健康组(P<0.05),LVEF、左心室短轴缩短率(LVFS)水平明显低于健康组(P<0.05);CHF患者血清miR-30a、CTGF水平与LVEDD、RVD、LVMI、NT-proBNP水平呈正相关(P<0.05),与LVEF、LVFS呈负相关(P<0.05);预后不良亚组患者血清miR-30a、CTGF、NT-proBNP、LVEDD、RVD、LVMI水平均明显高于预后良好亚组(P<0.05),LVFS、LVEF水平明显低于预后良好亚组(P<0.05);血清miR-30a、CTGF水平预测CHF患者不良预后的曲线下面积(AUC)分别为0.884、0.875,对应截断值分别为1.89、1 227.29 ng/L,灵敏度分别为76.7%、70.0%,特异度分别为86.8%、89.7%;两者联合预测CHF患者不良预后的AUC为0.948,其灵敏度、特异度分别为93.3%、80.9%。结论:miR-30a、CTGF在CHF患者血清中水平显著升高,与心室重构相关,两者水平有助于判断CHF患者预后情况。

Objective:To explore the relationship between the expression levels of serum microRNA-30a(miR-30a)and connective tissue growth factor(CTGF)and ventricular remodeling and prognosis in pa-tients with chronic heart failure(CHF).Methods:98 CHF patients diagnosed and treated in our hospital from March 2016 to May 2019 were selected as CHF group,and 98 healthy persons were selected as healthy group.The serum levels of miR-30a,CTGF and NT proBNP were detected;Pearson method to analyze the correlation between serum miR-30a and CTGF levels and NT-proBNP,cardiac function and ventricular remodeling indica-tors in CHF patients,and the correlation between serum miR-30a and CTGF levels and NT-proBNP in patients with poor prognosis of CHF;the serum miR-30a,CTGF and baseline data of CHF patients with different prog-nosis were compared between the two groups;Objective:to evaluate the diagnostic value of serum miR-30a and CTGF levels on the prognosis of CHF patients.Results:The levels of serum miR-30a,CTGF,NT-proBNP,LVEDD,right ventricular diameter(RVD),and left ventricular mass index(LVMI)of CHF group were signif-icantly higher than those of healthy group(P<0.05).LVEF and left ventricular short axis shortening rate(LVFS)levels were significantly lower than those of the healthy group(P<0.05);serum miR-30a and CTGF levels in CHF patients were positively correlated with LVEDD,RVD,LVMI,and NT-proBNP levels(P<0.05),and negatively correlated with LVEF and LVFS(P<0.05);the serum levels of miR-30a,CTGF,NT-proBNP,LVEDD,RVD and LVMI in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup(P<0.05),and the LVFS and LVEF levels were significantly lower than those in the good prognosis subgroup(P<0.05).The area under the curve(AUC)of serum miR-30a and CTGF in pre-dicting the adverse prognosis of CHF patients were 0.884 and 0.875,and the corresponding cut-off values were 1.89 and 1227.29 ng/L respectively,the sensitivity were 76.7%and 70.0%respectively,and the specificity were 86.8%and 89.7%respectively.The AUC of combined prediction of adverse prognosis in CHF patients was 0.948,and the sensitivity and specificity were 93.3%and 80.9%,respectively.Conclusions:The serum levels of miR-30a and CTGF are significantly increased in CHF patients,which are related to ventricular remod-eling,and the levels of miR-30a and CTGF are helpful to evaluate the prognosis of CHF patients.