慢性心力衰竭患者血清LncRNA MEG3表达水平及临床意义

Expression level and clinical significance of serum maternally expressed gene 3 of long non-coding RNA in patients with chronic heart failure

目的通过检测慢性心力衰竭(CHF)患者血清长链非编码RNA人母系表达基因3(LncRNA MEG3)表达水平,对其临床意义进行探究。方法选取2017年9月至2019年12月于保定市第一中心医院收治的确诊CHF患者115例作为CHF组,另选取同时期本院健康体检者82例为对照组;超声心动图测量左室射血分数(LVEF)及左室舒张末期内径(LVEDD);ELISA法检测血清中N末端脑钠肽前体(NT-proBNP)水平;实时荧光定量PCR(qRT-PCR)检测血清MEG3表达情况;MEG3表达与NT-proBNP、LVEF、LVEDD间相关性采用Pearson相关系数法进行分析;受试者工作特征(ROC)曲线评估样本中MEG3表达水平对CHF的诊断价值;使用Logistic回归分析影响CHF患者发生心脏不良事件的因素。结果与对照组比较,CHF组患者血清中NT-proBNP水平、LVEDD和MEG3表达显著增加,LVEF则显著降低(P<0.05),且MEG3表达水平随疾病严重程度增加;CHF组血清中MEG3表达与NT-proBNP、LVEDD均呈显著正相关(r=0.359,P=0.001;r=0.487,P=0.000),而与LVEF呈显著负相关(r=-0.461,P=0.000);MEG3评估CHF发生的曲线下面积0.771,灵敏度61.74%,特异性91.46%;多因素分析发现,MEG3≥1.237、年龄≥5年、心功能分级(Ⅲ~Ⅳ级)均是导致CHF患者心脏不良事件的独立危险因素(P<0.05)。结论CHF患者血清中MEG3表达水平与疾病严重程度密切相关,具有疾病严重程度及预后评估的潜能。

Objective To detect expression level of serum maternally expressed gene 3(MEG3)of long non-coding RNA(LncRNA)and discuss the clinical significance in patients with chronic heart failure(CHF).Methods CHF patients(n=115)were chosen into CHF group and healthy controls(n=82)were chosen into control group from the First Central Hospital of Baoding City from Sept.2017 to Dec.2019.The levels of left ventricular ejection fraction(LVEF)and left ventricular end-diastolic inner diameter(LVEDD)were detected by using echocardiogram.The level of N-terminal pro-brain natriuretic peptide(NT-proBNP)was detected by using ELISA,and MEG3 expression was detected by using qRT-PCR.The correlation among MEG3 expression,NT-proBNP,LVEF and LVEDD was analyzed by using Pearson correlation coefficient method.The diagnosis value of MEG3 expression to CHF was reviewed in samples by using receiver operating characteristic curve(ROC curve).The influence factors of adverse cardiac events were analyzed by using Logistic regression analysis in CHF patients.Results The levels of NT-proBNP and LVEDD and MEG3 expression increased significantly and LVEF level decreased significantly in CHF group compared with control group(P<0.05),and level of MEG3 expression increased along with the severity of the disease.MEG3 expression was positively correlated to NT-proBNP(r=0.359,P=0.001)and LVEDD(r=0.487,P=0.000)significantly,and negatively correlated to LVEF(r=-0.461,P=0.000)significantly in CHF group.The area under ROC curve was 0.771,sensitivity was 61.74%and specificity was 91.46%of MEG3 in reviewing CHF.The multi-factor analysis showed that MEG3≥1.237,age≥5,NYHA classification of heart function(classⅢ-Ⅳ)were all independent risk factors of adverse cardiac events in CHF patients(P<0.05).Conclusion The level of MEG3 expression is closely correlated to severity of the disease in CHF patients,and has a reviewing potential to disease severity and prognosis.