血清miR-181c-miR-144-3p表达在心力衰竭诊断及预后评估中的价值

Value of serum expression of miR-181c and miR-144-3p in the diagnosis and prognosis evaluation for heart failure

目的探讨血清中微小RNA-181c(miR-181c)、微小RNA-144-3p(miR-144-3p)表达在心力衰竭诊断及预后评估中的价值。方法选取2020年6月至2022年6月接诊的心力衰竭患者118例,根据患者1年预后情况,将心力衰竭患者分为预后良好组86例和预后不良组32例,选择体检的健康人员80例作为对照组,实时荧光定量PCR检测血清中miR-181c、miR-144-3p水平,比较各组血清中miR-181c、miR-144-3p水平,多因素Logistic回归分析心力衰竭患者1年预后不良的危险因素,ROC曲线评价miR-181c、miR-144-3p水平对心力衰竭患者预后不良的预测价值。结果与对照组比较,心力衰竭组患者血清中miR-181c表达水平显著降低,miR-144-3p表达水平显著升高,差异有统计学意义(P<0.05)。与Ⅰ~Ⅱ级患者比较,Ⅲ、Ⅳ级的心力衰竭患者中血清中miR-181c水平显著降低,miR-144-3p水平显著升高(P<0.05);与Ⅲ级患者比较,Ⅳ级心力衰竭患者血清中miR-181c水平显著降低,miR-144-3p水平显著升高,差异有统计学意义(P<0.05)。预后不良组的Hcy、miR-144-3p水平显著高于预后良好组,LVEF、血红蛋白、miR-181c水平显著低于预后良好组,差异有统计学意义(P<0.05)。Hcy、miR-144-3p是影响心力衰竭患者1年预后不良的独立危险因素,而miR-181c的是保护因素(P<0.05)。血清miR-181c、miR-144-3p水平单独和二者联合预测心力衰竭患者1年预后不良的AUC分别为0.896、0.797、0.948,二者联合预测价值优于单独预测。结论心力衰竭患者血清miR-181c表达水平降低,miR-144-3p表达水平升高,与患者心功能及预后有关,可能作为心力衰竭诊断和预后评估的标志物。

Objective To investigate the value of serum expression of microRNA-181c(miR-181c)and microRNA-144-3p(miR-144-3p)in the diagnosis and prognosis evaluation for heart failure(HF).Methods A total of 118 HF patients visited our hospital from June 2020 to June 2022 were enrolled as the subjects,they were assigned into good prognosis group(n=86)and poor prognosis group(n=32)based on the 1-year prognosis result,and 80 healthy individuals who underwent physical examination were as the control group.Real-time quantitative reverse transcription polymerase chain reaction(RT-qPCR)was applied to detect the serum levels of miR-181c and miR-144-3p.Multivariate Logistic regression was performed to analyze the risk factors for 1-year poor prognosis,and receiver operating characteristic(ROC)was conducted to evaluate the predictive value of miR-181c and miR-144-3p levels for poor prognosis of HF patients.Results Compared with the control group,the serum expression level of miR-181c of HF patients was obviously decreased,while the expression level of miR-144-3p was obviously increased(P<0.05).The improvement of serum expression of miR-181c and miR-144-3p was more pronounced in HF patients of grades Ⅲ-Ⅳ versus those of grades Ⅰ-Ⅱ(P<0.05),similarly,grades Ⅳ versus grades Ⅲ(P<0.05).The serum levels of Hcy and miR-144-3p in the poor prognosis group were obviously higher than those of the good prognosis group,while the serum levels of left ventricular ejection fraction(LVEF),hemoglobin,and miR-181c were obviously lower(P<0.05).The homocysteine(Hcy)and miR-144-3p were independent risk factors for 1-year poor prognosis in HF patients,while miR-181c was a protective factor(P<0.05).The area under the ROC curve(AUC)of miR-181c and miR-144-3p for predicting 1-year poor prognosis in HF patients regardless of alone and in combination was 0.896,0.797,and 0.948,respectively,the combined predictive value of the two was better than that predicted alone.Conclusion The serum expression of miR-181c decreases in HF patients,while miR-144-3p expression level increases,which are related to the patients’cardiac function and prognosis,and may serve as markers for the diagnosis and prognosis in the evaluation for HF.