血清miR-210、miR-423联合氨基末端脑利钠肽前体诊断维持性血液透析心血管事件的价值

Value of miR-210, miR-423 combined with N-terminal probrain natriuretic peptide in the diagnosis of cardiovascular events in maintenance hemodialysis patients

目的探讨血清miR-210、miR-423水平联合氨基末端脑利钠肽前体(NT-proBNP)诊断维持性血液透析(MHD)患者心血管事件发生的价值。方法选取2016年1月至2019年12月海口市骨科与糖尿病医院收治的152例MHD患者,根据在随访6个月期间是否发生心血管事件将患者分为心血管事件组(60例)和无心血管事件组(92例)。采用实时定量PCR法检测两组血清miR-210、miR-423水平,采用酶联免疫吸附法测定NT-proBNP水平。应用多因素logistic回归分析MHD患者发生心血管事件的危险因素。采用受试者工作特征(ROC)曲线分析血清miR-210、miR-423及NT-proBNP水平诊断MHD患者心血管事件发生的价值。结果心血管事件组的血清miR-210、miR-423及NT-proBNP水平均明显高于无心血管事件组(均P<0.001)。多因素logistic回归分析显示,血清miR-210(OR=2.318,95%CI:1.698~5.112)、miR-423(OR=1.850,95%CI:1.294~3.486)及NT-proBNP(OR=2.627,95%CI:1.815~6.102)水平升高是MHD患者发生心血管事件的危险因素(均P<0.05)。ROC曲线分析显示,miR-210、miR-423联合NT-proBNP诊断MHD患者心血管事件发生的曲线下面积(0.938,95%CI:0.879~0.993)最大,高于三项指标的单项诊断(均P<0.05),其灵敏度和特异度分别为97.0%和84.6%。结论发生心血管事件患者的血清miR-210、miR-423及NT-proBNP水平明显升高,是MHD患者发生心血管事件的危险因素,三项联合检测有助于诊断心血管事件的发生。

Objective To investigate the value of serum miR-210,miR-423 levels combined with NT-proBNP in the diagnosis of cardiovascular events in maintenance hemodialysis(MHD)patients.Methods From January 2016 to December 2019,152 patients with MHD admitted to Haikou orthopedics and diabetes hospital were selected and divided into cardiovascular event group(60 cases)and no cardiovascular event group(92 cases)according to whether cardiovascular events occurred during the follow-up period of 6 months.The real-time quantitative PCR were used to detect the serum miR-210 and miR-423 levels in the two groups,and the level of NT-proBNP was determined by enzyme-linked immunosorbent assay.Multivariate logistic regression was used to analyze the risk factors of cardiovascular events in MHD patients.Receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-210,miR-423 and NT-proBNP levels in the diagnosis of cardiovascular events in MHD patients.Results The serum levels of miR-210,miR-423 and NT-proBNP in the cardiovascular event group were significantly higher than those in the non-cardiovascular event group(all P<0.001).Multivariate logistic regression analysis showed that serum miR-210(OR=2.318,95%CI:1.698-5.112),miR-423(OR=1.850,95%CI:1.294-3.486)and NT-proBNP(OR=2.627,95%CI:1.815-6.102)was a risk factor for cardiovascular events in MHD patients(all P<0.05).ROC curve showed that miR-210 and miR-423 combined with NT-proBNP in the diagnosis of cardiovascular events in MHD patients had the largest area under the curve(AUC=0.938,95%CI:0.879-0.993),and their sensitivity and specificity were 97.0%and 84.6%,respectively.Conclusions The levels of serum miR-210,miR-423 and NT-proBNP in patients with cardiovascular events were significantly increased,which were the risk factors of cardiovascular events in MHD patients,and the combination of the three items was helpful to the diagnosis of cardiovascular events.