血清miR-22和miR-24表达在高龄老年慢性心力衰竭近期预后中的应用

Application of serum miR-22 and miR-24 expression in the short-term prognosis of elderly patients with chronic heart failure

目的探讨血清微小核糖核酸(miR)-22和miR-24表达在高龄老年慢性心力衰竭(CHF)近期预后的临床价值。方法收集2020年9月~2022年9月在东部战区总医院入院治疗的107例高龄老年CHF患者,根据随访6个月内是否发生主要不良心血管事件(MACE)分为MACE组(n=43)和非MACE组(n=64);qRT-PCR法检测血清miR-22和miR-24表达水平;Logistic回归分析高龄老年CHF患者发生MACE的影响因素;ROC曲线分析血清miR-22和miR-24对高龄老年CHF近期预后的评估价值。结果MACE组尿素氮(BUN)、肌酐(Cr)水平高于非MACE组,MACE组舒张早期二尖瓣血流速度与晚期的比值(E/A)低于非MACE组,差异均具有统计学意义(均P<0.01);MACE组血清miR-22水平高于非MACE组,miR-24水平低于非MACE组(均P<0.01);miR-22是高龄老年CHF患者发生MACE的危险因素,miR-24是保护因素(均P<0.01);血清miR-22和miR-24两者联合诊断CHF患者预后的AUC为0.921,敏感度为86.05%,特异性为89.94%,优于血清miR-22和miR-24各自单独诊断(Z二者联合-miR-22=2.783、Z二者联合-miR-24=2.147)。结论血清miR-22是高龄老年CHF患者发生MACE的危险因素,miR-24是保护因素,对高龄老年CHF预后评估具有较好的临床应用价值。

AIM To Exploring the clinical value of serum miR-22 and miR-24 expression in the shortterm prognosis of elderly patients with chronic heart failure(CHF).METHODS A total of 107 elderly CHF patients admitted to the Eastern Theater Command General Hospital from September 2020 to September 2022 were collected and divided into the MACE group(n=43)and non MACE group(n=64)based on whether there were major cardiovascular adverse events(MACE)within 6 months of follow-up;The expression levels of serum miR-22 and miR-24 were detected by qRT PCR method;Logistic regression analysis of the influencing factors of MACE in elderly CHF patients;Receiver operating characteristic was used to analyze the value of serum miR-22 and miR-24 in evaluating the short-term prognosis of elderly CHF.RESULTS The levels of Blood urea nitrogen(BUN)and creatinine(Cr)in the MACE group were higher than those in the non MACE group,and the ratio of early diastolic mitral flow velocity to late diastolic flow velocity(E/A)in the MACE group was lower than that in the non MACE group,with statistically significant differences(all P<0.01);The serum miR-22 level in the MACE group was higher than that in the non MACE group,while the miR-24 level was lower than that in the non MACE group(all P<0.01);MiR-22 is a risk factor for MACE in elderly CHF patients,while miR-24 is a protective factor(all P<0.01);The AUC of the combined diagnosis of serum miR-22 and miR-24 for CHF patients is 0.921,with a sensitivity of 86.05%and a specificity of 89.94%,which is superior to the individual diagnosis of serum miR-22 and miR-24(Z combined with miR-22=2.783,Z combined with miR-24=2.147).Conclusion Serum miR-22 is a risk factor for MACE in elderly CHF patients,while miR-24 is a protective factor,which has good clinical application value for evaluating the prognosis of elderly CHF.