血清LncRNA FAF、ITIH4在慢性心力衰竭患者中的表达意义及对预后的预测价值

Expression significance of serum LncRNA FAF and ITIH4 in patients with chronic heart failure and prognostic value

目的探讨血清长链非编码RNA(LncRNA)FAF、间α胰蛋白酶抑制因子重链4(ITIH4)在慢性心力衰竭(CHF)患者中的表达意义及对预后的预测价值。方法选择2020年1月—2022年1月安徽医科大学第二附属医院急诊内科收治的CHF患者187例为CHF组,再根据NYHA心功能分级分为Ⅱ级亚组65例,Ⅲ级亚组77例,Ⅳ级亚组45例。于同期招募健康志愿者103例为健康对照组。2组受试者均检测血清LncRNA FAF表达和ITIH4水平,CHF患者出院后随访12个月,统计随访期间主要不良心血管事件(MACE)发生率;多因素Logistic回归分析影响CHF患者发生MACE的因素;受试者工作特征(ROC)曲线分析LncRNA FAF、ITIH4预测CHF患者发生MACE的价值。结果CHF组血清LncRNA FAF表达、ITIH4水平低于健康对照组(t/P=24.469/<0.001、35.196/<0.001)。血清LncRNA FAF表达、ITIH4水平Ⅳ级亚组低于Ⅲ级亚组低于Ⅱ级亚组(F/P=91.653/<0.001、102.345/<0.001)。MACE亚组血清LncRNA FAF表达,ITIH4水平低于非MACE亚组(t/P=13.556/<0.001、6.293/<0.001)。NYHAⅣ级、高水平NT-proBNP是CHF患者发生MACE的危险因素[OR(95%CI)=4.627(2.245~9.538)、2.284(1.505~3.468)],高表达LncRNA FAF、高水平ITIH4是保护因素[OR(95%CI)=0.599(0.425~0.844)、0.666(0.478~0.928)]。LncRNA FAF、ITIH4及二者联合预测CHF患者发生MACE的曲线下面积为0.796、0.801、0.896,二者联合预测曲线下面积高于单独预测(Z=2.453、2.404,均P<0.001)。结论CHF患者血清LncRNA FAF表达和ITIH4水平均降低,且与不良预后有关,联合LncRNA FAF和ITIH4可预测CHF患者预后不良风险。

Objective To investigate the expression significance of serum long non-coding ribonucleic acid(LncRNA)FAF and inter alpha trypsin inhibitor heavy chain 4(ITIH4)in patients with chronic heart failure(CHF)and their prognostic value.Methods A total of 187 patients with CHF admitted to the Department of Emergency,the Second Affiliated Hospital of Anhui Medical University from January 2020 to January 2022 were selected as CHF group,and then divided into GradeⅡsubgroup(65 cases),gradeⅢsubgroup(77 cases),and gradeⅣsubgroup(45 cases)according to NYHA cardiac function classification.In the same period,103 healthy volunteers were recruited as control group.Serum LncRNA FAF expression and ITIH4 level were detected,and the incidence of major adverse cardiovascular events(MACE)during follow-up was analyzed for 12 months after discharge.Multivariate Logistic regression analysis was conducted to analyze the factors affecting the occurrence of MACE in CHF patients,and the value of LncRNA FAF and ITIH4 in predicting the occurrence of MACE in CHF patients was analyzed by receiver operating characteristic(ROC)curve.Results Serum LncRNA FAF expression and ITIH4 level in CHF group were lower than those in control group(t/P=24.469/<0.001,35.196/<0.001).Serum LncRNA FAF expression and ITIH4 level in gradeⅣgroup were lower than those in gradeⅢand gradeⅡgroups(F/P=91.653/<0.001,102.345/<0.001).Serum LncRNA FAF expression and ITIH4 level in MACE group were lower than those in non-MACE group(t/P=13.556/<0.001,6.293/<0.001).NYHA gradeⅣand high level of NT-pro BNP were risk factors for MACE in CHF patients,high expression of LncRNA FAF and high level of ITIH4 were protective factors[OR(95%CI)=4.627(2.245-9.538),2.284(1.505-3.468),0.599(0.425-0.844),0.666(0.478-0.928)].The area under the curve of LncRNA FAF,ITIH4 and combined detection in predicting the occurrence of MACE in CHF patients was 0.796,0.801 and 0.896,and the area under the curve of combined prediction was higher than that of single prediction(Z=2.453,2.404,all P<0.001).Conclusion Serum LncRNA FAF expression and ITIH4 level are decreased in CHF patients,and are associated with poor prognosis.Combining LncRNA FAF and ITIH4 can predict the risk of poor prognosis in CHF patients.