摘要
目的观察慢性心力衰竭(chronic heart failure,CHF)患者血清肾上腺髓质中段肽(mid-regional pro-adrenomedullin,MR-proADM)水平及miR-138-5p表达变化,探讨二者预测CHF患者发生心血管不良事件(major adverse cardiovascular events,MACE)的价值。方法CHF患者103例为观察组,其中NYHA心功能分级Ⅱ49例,Ⅲ级31例,Ⅳ级23例;同期体检健康者100例为对照组。2组采用实时荧光定量PCR法检测血清miR-138-5p相对表达量,采用ELISA法检测血清MR-proADM水平,采用荧光免疫吸附法检测血清N末端脑钠肽前体(N-terminal brain natriuretic peptide,NT-proBNP)水平,行超声心动图检查测定左室射血分数(left ventricular ejection fraction,LVEF)。CHF患者均给予规范治疗并随访6个月,发生MACE者37例为MACE组,未发生MACE者66例为非MACE组。比较观察组与对照组、不同NYHA心功能分级CHF患者、MACE组与非MACE组血清MR-proADM、NT-proBNP水平,miR-138-5p相对表达量及LVEF;Pearson相关法分析CHF患者血清MR-proADM水平、miR-138-5p表达与血清NT-proBNP水平、LVEF的相关性;绘制ROC曲线,评估血清MR-proADM、miR-138-5p预测CHF患者发生MACE的效能。结果观察组血清MR-proADM[(729.18±97.43)nmol/L]、NT-proBNP[(1688.32±264.19)ng/L]水平均高于对照组[(527.64±82.50)nmol/L、(357.45±96.36)ng/L](P<0.05),血清miR-138-5p相对表达量(0.93±0.22)及LVEF[(53.75±14.36)%]均低于对照组[1.34±0.18、(68.19±13.22)%](P<0.05)。NYHA心功能分级Ⅱ、Ⅲ、Ⅳ级CHF患者血清MR-proADM[(638.76±95.81)、(721.60±89.57)、(837.24±105.49)nmol/L]、NT-proBNP[(903.56±267.40)、(1798.21±285.49)、(2764.58±316.97)ng/L]水平均依次升高(P<0.05),血清miR-138-5p相对表达量(1.05±0.19、0.90±0.20、0.77±0.15)、LVEF[(61.43±15.50)%、(52.98±13.49)%、(45.32±15.17)%]均依次降低(P<0.05)。CHF患者血清MR-proADM水平与NT-proBNP水平呈正相关(r=0.672,P<0.05),与LVEF呈负相关(r=-0.725,P<0.05);血清miR-138-5p表达与NT-proBNP水平呈负相关(r=-0.708
Objective To observe the changes of serum mid-regional pro-adrenomedullin(MR-proADM)level and miR-138-5 p expression in patients with chronic heart failure(CHF),and to explore their values to the prediction of major adverse cardiovascular events(MACE).Methods In 103 patients with CHF(observation group),there were 49 patients in NYHA class Ⅱ,31 patients in class Ⅲ and 23 patients in class Ⅳ,and another 100 healthy volunteers were as controls(control group).The relative expression of serum miR-138-5 p was detected by real-time fluorescence quantitative PCR,the level of serum MR-proADM was detected by ELISA,the level of serum N-terminal brain natriuretic peptide(NT-proBNP)was detected by fluorescence immunosorbent assay,and left ventricular ejection fraction(LVEF)was measured by echocardiography.The patients with CHF were given standard therapy and were followed up for 6months.According to whether there were MACE,103patients with CHF were divided into MACE group(n=37)and non-MACE group(n=66).The levels of serum MR-proADM and NT-proBNP,the miR-138-5p relative expression and LVEF were compared between observation group and control group,in CHF patients with different NYHA cardiac function classifications,and between MACE group and non-MACE group.Pearson correlation method was used to analyze the correlations of serum MR-proADM and miR-138-5p with NT-proBNP and LVEF in patients with CHF.ROC curve was drawn to evaluate the efficiencies of serum MR-proADM and miR-138-5p on predicting MACE in patients with CHF.Results The levels of serum MR-proADM and NT-proBNP were higher in observation group[(729.18±97.43)nmol/L,(1688.32±264.19)ng/L]than those in control group[(527.64±82.50)nmol/L,(357.45±96.36)ng/L](P<0.05),and the miR-138-5p relative expression and LVEF were lower in observation group[0.93±0.22,(53.75±14.36)%]than those in control group[1.34±0.18,(68.19±13.22)%](P<0.05).The serum levels of MR-proADM[(638.76±95.81),(721.60±89.57),(837.24±105.49)nmol/L]and NT-proBNP[(903.56±267.40),(1798.21±285.49),(2
作者
刘楠楠
朱芳一
霍建霞
LIU Nan-nan;ZHU Fang-yi;HUO Jian-xia(Department of Arrhythmia,Qinghai Cardiovascular and Cerebrovascular Disease Hospital,Xining,Qinghai 810000,China)
出处
《中华实用诊断与治疗杂志》
2022年第7期719-723,共5页
Journal of Chinese Practical Diagnosis and Therapy
基金
青海省医药卫生科技项目计划(2019-wjzdx-35)。
