血清ACE2、miR-421在慢性心力衰竭患者中水平及其临床意义

Levels and clinical significance of serum ACE2 and miR-421 in patients with chronic heart failure

目的探讨慢性心力衰竭(CHF,心衰)患者血清血管紧张素转换酶2(ACE2)、微小RNA-421(miR-421)表达及与患者心功能的相关性。方法选取2021年3月至2022年10月于北京航天总医院收治的127例CHF患者作为观察组,另外选取150例本院同期无心衰患者作为对照组。记录超声参数左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV);采用酶联免疫吸附法(ELISA)检测血清ACE2表达水平,采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清miR-421表达水平,并进行组间比较;采用Spearman分析CHF患者血清ACE2、miR-421表达水平相关性及两者与超声参数、纽约心脏病协会(NYHA)分级相关性。结果与对照组相比,观察组LVESD、LVEDD、LVEDV、LVESV及血清ACE2、miR-421表达水平均较高(P<0.05),LVEF较低(P<0.05);Spearman分析结果显示,CHF患者血清ACE2与miR-421表达水平呈正相关(P<0.05);CHF患者血清ACE2、miR-421表达水平与LVESD、LVEDD、LVEDV、LVESV、NYHA分级均呈正相关(P<0.05),与LVEF呈负相关(P<0.05)。结论CHF患者血清ACE2、miR-421均为高表达,且两者均与患者心功能状况密切相关,可能用于CHF的临床病情评估。

Objective To investigate the expression of serum angiotensin-converting enzyme 2(ACE2)and microRNA-421(miR-421)in patients with chronic heart failure(CHF)and their correlation with cardiac function.Methods A total of 127 patients with CHF admitted to Beijing Aerospace General Hospital from March 2021 to October 2022 were selected as the observation group.In addition,150 cases of patients without heart failure were selected as the control group.Left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)were recorded;enzyme-linked immunosorbent assay(ELISA)was used to detect the expression level of ACE2 in serum,real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression level of miR-421 in serum,and it was compared between the groups;Spearman was used to analyze the correlation between serum ACE2 and miR-421 expression levels in patients with CHF and their correlation with ultrasound parameters and New York Heart Association(NYHA)grading.Results Compared with the control group,the observation group had higher expression levels of LVESD,LVEDD,LVEDV,LVESV,and serum ACE2 and miR-421(P<0.05),while LVEF was lower(P<0.05).The Spearman analysis results showed a positive correlation(P<0.05)between serum ACE2 and miR-421 expression levels in CHF patients.The expression levels of serum ACE2 and miR-421 in CHF patients were positively correlated with LVESD,LVEDD,LVEDV,LVESV,and NYHA grading(P<0.05),and negatively correlated with LVEF(P<0.05).Conclusion Serum ACE2 and miR-421 are highly expressed in patients with CHF,and both are closely related to cardiac function,which may be used for clinical evaluation of CHF.