摘要
目的分析老年心力衰竭患者血微RNA(miRNA)-423-5p、miRNA-532-3p、miRNA-29b-5p水平与其心功能的关系。方法回顾性选取2022年1月至2023年11月三亚中心医院收治的老年心力衰竭患者68例作为观察组,选择同期收治的非心力衰竭老年患者20例作为对照组。对比两组临床资料[性别、年龄、体重指数、左心房内径(LAD)、左心室内径(LVD)、右心房内径(RAD)、右心室内径(RVD)、室间隔厚度(IVS)、左室射血分数(LVEF)、B型脑钠肽(BNP)、肌钙蛋白I(cTnI)、总胆固醇、甘油三酯、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、白细胞计数(WBC)、血小板计数(PLT)、丙氨酸转氨酶(ALT)等]。经荧光聚合酶链反应定量分析法检测两组血miRNA-423-5p、miRNA-532-3p、miRNA-29b-5p水平;分析观察组中不同心功能分级患者血miRNA-423-5p、miRNA-532-3p、miRNA-29b-5p水平差异;Spearman相关分析法分析血miRNA-423-5p、miRNA-532-3p、miRNA-29b-5p水平与心功能分级的相关性;绘制受试者操作特征(ROC)曲线分析各参数预测老年心力衰竭患者心功能分级Ⅲ~Ⅳ级的价值。结果两组的性别构成比、年龄、体重指数、RVD、总胆固醇、甘油三酯、LDL、HDL、WBC比较,差异均无统计学意义(P>0.05);观察组的LAD、LVD、RAD、IVS、BNP、cTnI、ALT均高于对照组,而LVEF、PLT均低于对照组,差异均有统计学意义(P<0.05)。观察组血miRNA-423-5p水平为1.08±0.12,高于对照组(0.54±0.06),而miRNA-532-3p、miRNA-29b-5p水平分别为1.14±0.13、1.08±0.11,均低于对照组(1.26±0.15、1.15±0.13),差异均有统计学意义(P<0.05)。随老年心力衰竭患者心功能分级升高,其血miRNA-423-5p水平升高,而miRNA-532-3p、miRNA-29b-5p水平降低,差异均有统计学意义(P<0.05)。老年心力衰竭患者miRNA-423-5p与心功能分级呈正相关(P<0.05),miRNA-532-3p、miRNA-29b-5p与心功能分级呈负相关(P<0.05)。ROC曲线显示,血miRNA-423-5p、miRNA-532-3p、miRNA-29b-5p联合预测老年心力衰竭心功能分级Ⅲ~Ⅳ级的敏感度、特异度、曲线下面积分别为82.43%、81.85%、0.864,高于单独预测结果。结论老年心力衰竭患者血miRNA-423-5p、miRNA-532-3p、miRNA-29b-5p呈异常表达,且与患者心功能分级有密切关系,联合检测三者对判断心功能分级有较高预测价值。
Objective To analyze the relationship between serum microRNA(miRNA)-423-5p,miRNA-532-3p and miRNA-29b-5p levels and cardiac function in elderly patients with heart failure.Methods Sixty elderly patients with heart failure admitted to Sanya Central Hospital from January 2022 to November 2023 were retrospectively selected as the observation group,and 20 elderly patients without heart failure admitted to our hospital at the same peniod were selected as the control group.Clinical data[gender,age,body mass index,left atrial diameter(LAD),left ventricular diameter(LVD),right atrial diameter(RAD),right ventricular diameter(RVD),interventricular septal thickness(IVS),left ventricular ejection fraction(LVEF),B-type brain natriuretic peptide(BNP),cardiac troponin I(cTnI),total cholesterol,triglycerides,low-density lipoprotein(LDL),high-density lipoprotein(HDL),white blood cell count(WBC),platelet count(PLT),alanine aminotransferase(ALT),etc.]of the two groups were compared.Serum miRNA-423-5p,miRNA-532-3p and miRNA-29b-5p levels were measured by fluorescence quantitative polymerase chain reaction.Serum miRNA-423-5p,miRNA-532-3p and miRNA-29b-5p levels in patients with different grades of cardiac function in the observation group were analyzed.Spearman correlation analysis method was used to analyze the correlation between serum miRNA-423-5p,miRNA-532-3p and miRNA-29b-5p levels and the grade of cardiac function.The receiver operating characteristic(ROC)curve was plotted to evaluate the value of above parameters in predicting grade Ⅲ-Ⅳ cardiac function in elderly patients with heart failure.Results There were no statistically significant differences in gender composition ratio,age,body mass index,RVD,total cholesterol,triglycerides,LDL,HDL,and WBC between the two groups(P>0.05);the LAD,LVD,RAD,IVS,BNP,cTnI,and ALT of the observation group were all higher than those of the control group,while LVEF and PLT were lower than those of the control group,and the differences were statistically significant(P<0.05).The level of miRNA-423-5p in the observation group was 1.08±0.12,which was higher than that in the control group(0.54±0.06),while miRNA-532-3p and miRNA-29b-5p were 1.14±0.13 and 1.08±0.11,respectively,which were lower than those in the control group(1.26±0.15,1.15±0.13),and the differences were statistically significant(P<0.05).As the grade of cardiac function increased,serum miRNA-423-5p and miRNA-29b-5p levels increased,and miRNA-532-3p levels decreased in elderly patients with heart failure,and the differences were statistically significant(P<0.05).miRNA-423-5p and miRNA-29b-5p were positively correlated with the grade of cardiac function(P<0.05),while miRNA-532-3p was negatively correlated with the grade of cardiac function in elderly patients with heart failure(P<0.05).ROC curve indicated that the sensitivity,specificity and area under the curve of the combination of miRNA-423-5p,miRNA-532-3p and miRNA-29b-5p for predicting grade Ⅲ-Ⅳ cardiac function in elderly patients with heart failure were 82.43%,81.85% and 0.864,which were higher than those of separate prediction.Conclusion The expression of miRNA-423-5p,miRNA-532-3p,and miRNA-29b-5p is abnormal in elderly patients with heart failure,and is closely related to the grade of cardiac function.Combined detection of the three is much helpful for determining the grade of cardiac function.
作者
张玉梅
梁冬
刘慧
赵曦雯
ZHANG Yu-mei;LIANG Dong;LIU Hui(Department of Geriatric Medicine,Sanya Central Hospital(the Third People's Hospital of Hainan Province),Sanya Hainan 572000,China;The Department of Respiratory and Critical Care Medicine,Sanya Central Hospital(the Third People's Hospital of Hainan Province),Sanya Hainan 572000,China)
出处
《临床和实验医学杂志》
2024年第24期2581-2586,共6页
Journal of Clinical and Experimental Medicine
基金
海南省自然科学基金项目(编号:3260MS010)
三亚市科技创新专项项目(编号:2022KJCX25)。
