血清miR-21与miR-210在先天性心脏病相关肺动脉高压中的表达及意义

Expression and significance of serum miR-21 and miR-210 in patients with congenital heart disease associated pulmonary hypertension

目的探究血清miR-21、mi R-210在先天性心脏病相关肺动脉高压中的表达及意义。方法选取2017年1月-2020年6月宁波市第四医院收治的先天性心脏病患者106例作为研究对象(先天性心脏病组),依据美国心脏病学会制定的肺动脉高压(pulmonaryarterialhypertension,PAH)诊断标准,将先天性心脏病患者是否合并PAH分为无PAH组36例及合并PAH组70例;同期选择于本院体检的健康人106名为对照组。检测研究对象心脏超声临床指标,左心室射血分数(LVEF)、左心室后壁(LVPWT)、主动脉瓣环内前后径(MA)。采用实时荧光定量PCR(q RT-PCR)仪检测血清中miR-21、miR-210水平,受试者工作特征曲线(ROC)分析血清miR-21、mi R-210水平对先天性心脏病合并PAH的诊断效能;应用二元Logistic回归分析先天性心脏病发生PAH的影响因素。结果与对照组相比,先天性心脏病组LVPWT、MA较高(P<0.05),LVEF较低(P<0.05);与对照组相比,无PAH组、合并PAH组血清miR-21、mi R-210表达水平较高(P<0.05),与无PAH组相比,合并PAH组血清miR-21、mi R-210表达水平及肺动脉收缩压较高(P<0.05);ROC曲线显示,miR-21对先天性心脏病合并PAH发生的曲线下面积(AUC)为0.772,其灵敏度、特异度分别为80.00%、63.90%;mi R-210对先天性心脏病合并PAH发生的AUC为0.810,其灵敏度、特异度分别为70.00%、80.60%;两者联合对先天性心脏病合并PAH发生的AUC为0.880,其灵敏度、特异度分别为88.90%、21.40%。Logistic回归分析显示,高水平miR-21、高水平mi R-210是先天性心脏病患者发生PAH的危险因素(P<0.05)。结论血清miR-21、mi R-210表达水平在先天性心脏病合并PAH患者呈高表达,有助于判断先天性心脏病患者是否合并PAH。

Objective To investigate the expression and significance of serum miR-21 and miR-210 in patients with congenital heart disease associated pulmonary arterial hypertension(PAH).Methods A total of 106 patients with congenital heart disease admitted to our hospital from January 2017 to June 2020 were selected as the research objects(congenital heart disease group),according to the diagnostic criteria of PAH formulated by American Heart Association,patients with congenital heart disease were divided into two groups:36 patients in non PAH group and 70 patients in PAH group;at the same time,106 healthy people were selected as the control group.The clinical indexes of echocardiography,including left ventricular ejection fraction(LVEF),left ventricular posterior wall thickness(LVPWT),and anteroposterior diameter(MA)were measured.The levels of serum mi R-21 and miR-210 were detected by real-time fluorescence quantitative PCR(qRT-PCR),receiver operating characteristic curve(ROC)was used to analyze the diagnostic efficacy of serum miR-21 and miR-210 levels in patients with congenital heart disease complicated with PAH;and binary Logistic regression was used to analyze the influencing factors of PAH in congenital heart disease.Results Compared with those in the control group,LVPWT and MA in congenital heart disease group were higher(P<0.05),LVEF was lower(P<0.05);compared with those in the control group,the levels of serum miR-21 and miR-210 were higher in non PAH group and PAH group(P<0.05),compared with those in the non PAH group,the levels of serum miR-21,miR-210 and pulmonary artery systolic pressure in PAH group were higher(P<0.05);ROC curve showed that the area under the curve(AUC)of miR-21 in predicting congenital heart disease with PAH was 0.772,and its sensitivity and specificity were 80.00%and 63.90%,respectively;the AUC of miR-210 was 0.810,and its sensitivity and specificity were 70.00%and 80.60%,respectively;the AUC of the combination of two methods was 0.880,and the sensitivity and specificity were 88.90%and 21.40%,respectively.Logistic regression analysis showed that high level of miR-21 and high level of miR-210 were risk factors for PAH in patients with congenital heart disease(P<0.05).Conclusion The expression levels of serum miR-21 and miR-210 are high in patients with congenital heart disease complicated with PAH,and they are helpful to judge whether the patients with congenital heart disease are complicated with PAH.