慢性心力衰竭患者血清中NAMPT mir-206表达及临床意义

The Expression and Clinical Significance of NAMPT and Mir-206 in Serum of Patients with Chronic Heart Failure

目的:探讨慢性心力衰竭患者血清中烟酰胺磷酸核糖转移酶(NAMPT)、mir-206表达及临床意义。方法:选取2020年1月至2021年8月在本院接受治疗的慢性心力衰竭患者76例为心衰组,另选取同期在本院体检健康者34例为健康组。采用酶联免疫吸附法检测血清中NAMPT水平,实时荧光定量PCR法检测血清mir-206水平;对患者进行心功能分级,比较不同心功能分级患者血清NAMPT、mir-206水平,并分析NAMPT、mir-206水平与左室舒张末期内径(LVEDD)、B型钠尿肽(BNP)、左心室射血分数(LVEF)的相关性,利用受试者工作特征曲线(ROC)分析血清NAMPT、mir-206水平对慢性心力衰竭患者的预测价值。结果:心衰组NAMPT、LVEDD、BNP水平高于健康组(P<0.05),mir-206、LVEF水平低于健康组(P<0.05);慢性心力衰竭患者血清中NAMPT水平随着心功能分级的增加逐渐升高(P<0.05),mir-206水平随着心功能分级的增加逐渐降低(P<0.05);Pearson结果显示,慢性心力衰竭患者血清NAMPT水平与LVEDD、BNP水平均呈正相关(r=0.750、0.757,P<0.05),与LVEF水平呈负相关(r=-0.759,P<0.05);血清mir-206水平与LVEDD、BNP水平均呈负相关(r=-0.775、-0.883,P<0.05),与LVEF水平呈正相关(r=0.819,P<0.05);ROC结果显示,血清NAMPT、mir-206水平预测慢性心力衰竭的曲线下面积(AUC)分别为0.853(95%CI:0.773-0.913)、0.981(95%CI:0.935-0.998),对应的特异度分别为61.76%、97.06%,灵敏度分别为93.42%、88.16%,血清NAMPT、mir-206二者联合预测慢性心力衰的AUC为0.993,特异度为97.06%,灵敏度为96.05%。结论:慢性心力衰竭患者血清NAMPT表达水平升高、mir-206表达水平降低,与患者心功能分级有关,对慢性心力衰竭的发生有一定的预测价值,有望成为诊断慢性心力衰竭的生物学指标。

Objective:To investigate the expression and clinical significance of nicotinamide phosphoribose transferase(NAMPT)and mir-206 in the serum of patients with chronic heart failure.Methods:Seventy-six patients with chronic heart failure who were treated in our hospital from January 2020 to August 2021 were selected as the heart failure group.In addition,34 healthy people who underwent physical examination in this hospital during the same period were selected as the healthy group.Enzyme-linked immunosorbent assay was used to detect the level of NAMPT in serum,real-time fluorescent quantitative PCR method to detect the level of serum mir-206;the cardiac function of patients was graded,the serum levels of NAMPT and mir-206 in patients with different cardiac function classes were compared,the correlation between NAMPT,mir-206 levels and left ventricular end diastolic diameter(LVEDD),B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)was analyzed,and the receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum NAMPT and mir-206 levels in patients with chronic heart failure.Results:The levels of NAMPT,LVEDD and BNP in the heart failure group were higher than those in the healthy group(P<0.05),and the levels of mir-206 and LVEF were lower than those in the healthy group(P<0.05);the level of NAMPT in serum of patients with chronic heart failure gradually increased with the increase of cardiac function classification(P<0.05),and the level of mir-206 gradually decreased with the increase of cardiac function classification(P<0.05);Pearson results showed that the serum NAMPT level in patients with chronic heart failure was positively correlated with LVEDD and BNP levels(r=0.750,0.757,P<0.05),and negatively correlated with LVEF level(r=-0.759,P<0.05);serum mir-206 level was negatively correlated with LVEDD and BNP levels(r=-0.775,-0.883,P<0.05),and positively correlated with LVEF level(r=0.819,P<0.05);ROC results showed that the area under the curve(AUC)of serum NAMPT and mir-206 levels predicting chronic heart failure was 0.853(95%CI:0.773-0.913)and 0.981(95%CI:0.935-0.998),respectively,the corresponding specificity was 61.76%and 97.06%,respectively,the sensitivity was 93.42%and 88.16%,respectively,the AUC of the combination of serum NAMPT and mir-206 predicting chronic heart failure was 0.993,with a specificity of 97.06%,and a sensitivity of 96.05%.Conclusion:The expression level of serum NAMPT in patients with chronic heart failure increases,and the expression level of mir-206 decreases.They are related to the patient's heart function classification,have certain predictive values for the occurrence of chronic heart failure and are expected to become biological indicators for the diagnosis of chronic heart failure.