扩张型心肌病miR-133a、miR-210、TGF-β检测及其与免疫指标相关性分析

Dilated cardiomyopathy miR-133a,miR-210,TGF-βdetection and its correlation analysis with immune indicators

目的分析扩张型心肌病患者外周血微小RNA(miR)-133a、miR-210、转化生长因子-β(TGF-β)表达状况及其与免疫指标相关性。方法选取金华市人民医院于2020年1月—2023年1月期间收治的98例扩张型心肌病患者作为研究组,98例健康人作为对照组。检测miR-133a、miR-210、TGF-β1、TGF-β2表达量及免疫指标CD4^(+)T细胞表面CD25^(+)、CD69^(+)表达状况,分析在两组中的差异及miR-133a、miR-210、TGF-β1、TGF-β2与扩张型心肌病患者临床特征、免疫指标的关系,明确miR-133a、miR-210、TGF-β1、TGF-β2对扩张型心肌病的诊断价值。结果研究组miR-133a表达量低于对照组,miR-210、TGF-β1、TGF-β2表达量高于对照组(P<0.05)。miR-133a在心功能Ⅲ级~Ⅳ级、有心房颤动、有心力衰竭患者中表达降低,miR-210、TGF-β1、TGF-β2在心功能Ⅲ级~Ⅳ级、有心房颤动、有心力衰竭患者中表达升高(P<0.05)。研究组CD4^(+)T细胞表面CD25^(+)、CD69^(+)表达高于对照组(P<0.05)。miR-133a与扩张型心肌病患者免疫指标CD4^(+)T细胞表面CD25^(+)、CD69^(+)负相关(P<0.05);miR-210、TGF-β1、TGF-β2与扩张型心肌病患者免疫指标CD4^(+)T细胞表面CD25^(+)、CD69^(+)正相关(P<0.05)。miR-133a、miR-210、TGF-β1、TGF-β2诊断扩张型心肌病的截断值分别为0.78、2.74、1.32、2.69,AUC分别为0.821、0.865、0.898、0.800,四项联合诊断扩张型心肌病的AUC为0.943,高于单项诊断。结论miR-133a在扩张型心肌病中表达降低,miR-210、TGF-β1、TGF-β2表达升高,且与患者免疫状态有关,可作为扩张型心肌病诊断的参考指标。

Objective To analyze peripheral blood microRNA-133a,miR-210,and transforming growth factor in patients with dilated cardiomyopathy-β(TGF-β)expression status and its correlation with immune indicators.Methods Ninety-eight patients with dilated cardiomyopathy admitted to Jinhua People's Hospital from January 2020 to January 2023 were selected as the study group,while 98 healthy individuals were selected as the control group.The differences between the two groups and the relationship between miR-133a,miR-210,TGF-β1,TGF-β2 and clinical characteristics and immune indexes of patients with dilated cardiomyopathy were analyzed,and the diagnostic value of miR-133a,miR-210,TGF-β1,TGF-β2 in dilated cardiomyopathy was determined.Results The expression level of miR-133a in the study group was lower than that in the control group,with miR-210,TGF-β1and TGF-β2.The expression level of the study group was higher than that of the control group(P<0.05).The expression of miR-133a was decreased in patients with heart function gradeⅢtoⅣ,atrial fibrillation and heart failure,while the expression of miR-210,TGF-β1 and TGF-β2 was increased in patients with heart function gradeⅢtoⅣ,atrial fibrillation and heart failure(P<0.05).The expressions of CD25^(+)and CD69^(+)on CD4^(+)T cells in the study group were higher than those in the control group(P<0.05).MiR-133a was negatively correlated with CD25^(+)and CD69^(+)on the surface of CD4+T cells in patients with dilated cardiomyopathy(P<0.05).MiR-210,TGF-β1 and TGF-β2 were positively correlated with CD25^(+)and CD69^(+)on the surface of CD4^(+)T cells in patients with dilated cardiomyopathy(P<0.05).The cut-off values of miR-133a,miR-210,TGF-β1 and TGF-β2 in the diagnosis of dilated cardiomyopathy were 0.78,2.74,1.32 and 2.69,respectively,the AUC was 0.821,0.865,0.898 and 0.800,respectively,and the AUC of the combined diagnosis of the four was 0.943,higher than single diagnosis.Conclusion The expression of miR-133a decreased in dilated cardiomyopathy,and the expression of miR-210,TGF-β1 and TGF-β2 increased,which were related to the immune status of patients,they could be used as a reference index for the diagnosis of dilated cardiomyopathy.