彩色多普勒超声联合miR-222、miR-21对老年退行性心脏瓣膜病的诊断价值

Diagnostic Value of Color Doppler Ultrasound Combined with miR-222 and miR-21 in Senile Degenerative Heart Valvular Disease

目的:探究彩色多普勒超声联合微小RNA-222(miR-222)、微小RNA-21(miR-21)对老年退行性心脏瓣膜病的诊断价值。方法:选取2022年6月—2023年6月因不适(心悸、发力、胸痛等)在龙南市第一人民医院检查的患者100例作为研究组,以临床综合诊断为金标准,将其中确诊为老年退行性心脏瓣膜病的58例患者作为心脏瓣膜病组,并选取同时期在本院体检的健康志愿者90例作为正常组。所有患者行彩色多普勒超声检查,并检测miR-222、miR-21表达量。比较心脏瓣膜病组与正常组,以及不同严重程度瓣膜功能障碍患者miR-222、miR-21表达量,分析彩色多普勒超声、miR-222、miR-21联合诊断老年退行性心脏瓣膜病的价值。结果:彩色多普勒超声对老年退行性心脏瓣膜病的诊断准确度为84.00%(84/100),敏感度为82.76%(48/58),特异度为85.71%(36/42)。与正常组相比,心脏瓣膜病组miR-222、miR-21表达量均明显更高(P<0.05)。重度瓣膜功能障碍患者miR-222、miR-21表达量均明显高于轻度、中度患者,中度患者miR-222、miR-21表达量均高于轻度患者(P<0.05)。受试者操作特征(ROC)曲线分析显示,三项联合对老年退行性心脏瓣膜病诊断的曲线下面积(AUC)高于单项。结论:miR-222、miR-21在老年退行性心脏瓣膜病中表达水平较高,且随着病情严重程度的增加,miR-222、miR-21表达水平逐渐升高,联合检查彩色多普勒超声、miR-222、miR-21,具有较高诊断价值,可用于老年退行性心脏瓣膜病的临床诊断。

Objective:To explore the diagnostic value of color Doppler ultrasound combined with microRNA-222(miR-222)and microRNA-21(miR-21)in senile degenerative heart valvular disease.Method:A total of 100 patients who were examined in Longnan First People's Hospital from June 2022 to June 2023 due to discomfort(palpitation,force,chest pain,etc.)were selected as the study group,taking comprehensive clinical diagnosis as the gold standard,58 patients diagnosed with senile degenerative heart valvular disease were selected as the valvular heart disease group.In addition,90 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the normal group.All patients underwent color Doppler ultrasonography and the expression levels of miR-222 and miR-21 were detected.The expression levels of miR-222 and miR-21 were compared between the valvular heart disease group and the normal group and patients with different severity of valvular dysfunction.The value of combination of color Doppler ultrasound,miR-222 and miR-21 in the diagnosis of senile degenerative heart valvular disease were analyzed.Result:The diagnostic accuracy,sensitivity and specificity of color Doppler ultrasound for senile degenerative heart valvular disease were 84.00%(84/100),82.76%(48/58)and 85.71%(36/42)respectively.Compared with the normal group,the expression levels of miR-222 and miR-21 in the heart valvular disease group were significantly higher(P<0.05).The expression levels of miR-222 and miR-21 in patients with severe valvular dysfunction were significantly higher than those in mild and moderate patients,the expression levels of miR-222 and miR-21 in patients with moderate valvular dysfunction were significantly higher than those in mild and moderate patients(P<0.05).Receiver operating characteristics(ROC)curve analysis showed that the area under the curve(AUC)of the three combinations for the diagnosis of senile degenerative heart valvular disease was higher than that of the single diagnosis.Conclusion:The expression levels of miR-222 and miR-21 are high in senile degenerative heart valvular disease,and the expression levels of miR-222 and miR-21 gradually increase with the severity of the disease.The combined examination of color Doppler ultrasound,miR-222 and miR-21 have high diagnostic value and can be used in the clinical diagnosis of senile degenerative heart valvular disease.