冠心病慢性心力衰竭合并肺部感染者血清miRNA-155和miRNA-21的表达与意义

The expression of miRNA-155 and miRNA-21 in coronary artery disease patients with chronic heart failure and pulmonary infection and its clinical value

目的分析冠心病慢性心力衰竭(下称心衰)合并肺部感染者的血清miRNA-155和miRNA-21表达及临床意义。方法选择2018年5月至2020年5月在金华市中医医院住院的冠心病慢性心衰合并肺部感染患者42例为观察组。选择同期冠心病慢性心衰不合并肺部感染患者44例为心衰组,健康体检者45例为对照组。采用实时荧光PCR技术测定血清miRNA-155和miRNA-21的表达水平。采用酶联免疫吸附法测定血清N末端脑钠肽前体(NT-proBNP)和超敏C反应蛋白(hs-CRP)水平。绘制ROC曲线,分析血清miRNA-155、miRNA-21、NT-proBNP和hs-CRP在冠心病慢性心衰合并肺部感染患者中的诊断效能。结果观察组血清miRNA-155、mi RNA-21、NT-proBNP和hs-CRP水平均高于心衰组和对照组,心衰组上述指标均高于对照组(均P<0.05)。血清miRNA-155、miRNA-21、NT-proBNP和hs-CRP水平联合测定在冠心病慢性心衰合并肺部感染患者中的诊断灵敏度高于上述4项单一检测,特异度低于上述4项指标单一检测(均P<0.05)。结论冠心病慢性心衰合并肺部感染患者血清miRNA-155和miRNA-21增高,结合NT-proBNP和hs-CRP有助于肺部感染的诊断。

Objective To investigate the expression of serum miRNA-155 and miRNA-21 in coronary artery disease(CAD)patients with chronic heart failure(CHF)and pulmonary infection(PI).Methods A total of 42 CAD patients with CHR and PI who admitted to Jinhua Hospital of TCM were selected as observation group from May 2018 to May 2020.Meanwhile,44 CAD patients with CHF were selected as CHF group and 45 healthy subjects as control group.Serum miRNA-155 and miRNA-21 were measured by real-time fluorescence PCR.Serum NT-proBNP and hs-CRP were measured by enzyme linked immunosorbent assay.ROC curve was drawn to analyze the diagnostic efficacy of serum miRNA-155,miRNA-21,NT-proBNP and hs-CRP in CAD patients with CHF and PI.Results Serum miRNA-155,miRNA-21,NT-proBNP and hs-CRP were significantly higher in observation group than in CHF group and the control group,and higher in CHF group than in the control group(all P<0.05).ROC curve analysis showed that combined miRNA-155,mi RNA-21,NT-proBNP and hs-CRP had significantly higher sensitivity and lower specificity in diagnosis of PI in CAD patients with CHF than any one of above 4 parameters(all P<0.05).Conclusion Serum miRNA-155 and miRNA-21 increase in CAD patients with CHF and PI,which may improve diagnosis of PI when combined with NT-proBNP and hs-CRP.