miR-214和miR-29a与高血压患者左心室肥厚及心功能的关系

Relationship between miR-214、mi R-29a Level and Left Ventricular Hypertrophy and Heart Function in Patients with Hypertension

目的探究miR-214和miR-29a与高血压患者左心室肥厚(LVH)及心功能的关系。方法选取2020年2月至2021年6月诊治的高血压患者96例,根据超声检查结果分为高血压LVH组(34例)和单纯高血压组(62例)。收集两组患者的一般临床资料并进行比较;患者血浆miR-214和miR-29a水平通过实时荧光定量PCR(qRT-PCR)检测,并分析不同程度高血压LVH患者血浆miR-214、miR-29a水平的变化;利用彩色超声仪分析患者的左心室心功能指标;采用Pearson相关性分析高血压患者血浆miR-214与miR-29a水平相关性,及二者与E/A值的相关性;利用多因素logistic回归分析影响高血压患者发生LVH的危险因素;ROC曲线分析miR-214、miR-29a对高血压患者发生LVH的诊断价值。结果与单纯高血压组相比,高血压LVH组患者血浆miR-214、miR-29a表达水平明显升高,且miR-214及miR-29a水平随着LVH程度加重而不断上升(P<0.05)。与单纯高血压组相比,高血压LVH组患者E/A值明显下降(P<0.05)。Pearson相关性分析结果显示,高血压患者血浆miR-214与miR-29a水平呈显著正相关(P<0.05),血浆mi R-214、miR-29a水平与E/A值呈显著负相关(P<0.05)。多因素logistic回归分析显示,miR-214及miR-29a为影响高血压患者发生LVH的独立危险因素(P<0.05)。ROC曲线分析结果表明,miR-214、miR-29a及二者联合诊断高血压患者发生LVH的曲线下面积(AUC)分别为0.907、0.801、0.941;血浆miR-214水平、血浆miR-214联合miR-29a诊断高血压患者发生LVH的AUC均高于血浆miR-29a水平(P<0.05)。结论高血压LVH患者血浆miR-214、miR-29a呈高表达,其水平与患者心功能有密切联系,二者均可作为高血压LVH早期诊断的辅助生物标志物。

Objective To explore the relationship between miR-214,miR-29a level and left ventricular hypertrophy(LVH) and heart function in patients with hypertension.Methods Ninety-six patients with hypertension who came to our hospital for diagnosis and treatment from February 2020 to June 2021 were selected.According to the results of ultrasound examination,they were divided into 34 cases of hypertensive LVH group and 62 cases of simple hypertension group.The general clinical data of patients in the two groups were collected and compared;real-time fluorescent quantitative PCR(qRT-PCR) was used to detect the level of plasma miR-214 and miR-29a in patients,and change in plasma miR-214 and miR-29a level among patients with different degrees of hypertensive LVH was analyzed.A color ultrasound instrument was used to measure the left ventricular heart function indicators of patients.Pearson correlation was used to analyze the correlation between plasma miR-214 and miR-29a levels in hypertensive patients and the correlation between them and E/A value.Multivariate logistic regression analysis was used to analyze the risk factors of LVH in patients with hypertension.ROC curve was used to analyze the diagnostic value of miR-214 and miR-29a for LVH in hypertensive patients.Results Compared with the simple hypertension group,the expression level of plasma miR-214 and miR-29a of patients in the hypertensive LVH group was significantly higher,and the level of miR-214 and miR-29a continued to increase with the aggravation of LVH(P <0.05).Compared with the simple hypertension group,the E/A value in the hypertensive LVH group reduced significantly(P<0.05).The results of Pearson correlation analysis showed that the plasma levels of miR-214 and miR-29a were significantly positively correlated(P <0.05),and plasma miR-214 and miR-29a level in patients with hypertensive was significantly negatively correlated with E/A value(P <0.05).Multivariate logistic regression analysis showed that miR-214 and miR-29a were independent risk factors for LVH in patients with hypertension(P <0.05).ROC curve analysis results showed that the area under the curve(AUC) of miR-214,miR-29a and their combination in the diagnosis of LVH in patients with hypertension were 0.907,0.801 and 0.941;the AUC of plasma miR-214 and miR-214 combined with miR-29a in diagnosing LVH in hypertensive patients were higher than that of plasma miR-29a(P <0.05).Conclusions Plasma miR-214 and miR-29a are highly expressed in patients with hypertensive LVH,and their level are closely related to the heart function of patients.They can be used as auxiliary biomarkers for the early diagnosis of hypertensive LVH.