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    血清miR-139-3p水平变化与老年慢性心力衰竭病人预后的相关性研究

    Correlation between serum miR-139-3p level and prognosis in elderly patients with chronic heart failure

      摘要
    • 摘要:
      目的 分析老年慢性心力衰竭病人血清微小RNA-139-3p(miR-139-3p)表达水平与预后的关系。
      方法 选择162例老年慢性心力衰竭病人为观察组, 根据NYHA心功能分级将病人分为Ⅱ级67例, Ⅲ级53例, Ⅳ级42例, 根据是否发生心脏事件将病人分为心脏事件组44例和非心脏事件组118例; 选取同期157名体检者为对照组。检测各组血清miR-139-3p表达水平、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、血清B型脑钠肽(BNP)、血清肌钙蛋白Ⅰ(cTnⅠ)水平; 采用Pearson法分析老年慢性心力衰竭病人血清miR-139-3p水平与心功能指标相关性; 绘制ROC曲线分析血清miR-139-3p水平对老年慢性心力衰竭病人预后的预测价值。
      结果 与对照组比较, 观察组高血压、高脂血症比例及miR-139-3p、LVEDD、BNP、cTnI、TG、TC、LDL-C水平较高(P < 0.01), LVEF水平较低(P < 0.01)。老年慢性心力衰竭病人血清miR-139-3p水平与LVEDD、BNP、cTnI呈正相关关系(r=0.504、0.498、0.492, P < 0.01), 与LVEF呈负相关关系(r=-0.519, P < 0.01)。老年慢性心力衰竭心功能Ⅱ级、Ⅲ级、Ⅳ级病人血清miR-139-3p水平逐级升高(P < 0.01)。与非心脏事件组比较, 心脏事件组miR-139-3p水平及年龄、高血压比例及LVEDD、BNP、cTnI较高, LVEF较低(P < 0.01)。血清miR-139-3p预测老年慢性心力衰竭病人心脏事件的AUC为0.849(95%CI: 0.788~0.910), 截断值为2.98, 敏感度为81.8%, 特异性为76.3%。
      结论 血清miR-139-3p水平检测可为老年慢性心力衰竭病人的治疗及预后提供依据。

       

      Abstract:
      Objective To investigate the relationship between serum microRNA-139-3p (miR-139-3p) level and the prognosis of elderly patients with chronic heart failure.
      Methods A total of 162 elderly patients with chronic heart failure were selected as the observation group.According to NYHA cardiac function classification, the patients were divided into 67 cases of grade Ⅱ, 53 cases of grade Ⅲ and 42 cases of grade Ⅳ.According to whether a cardiac event occurred, the patients were divided into 44 cases of cardiac event group and 118 cases of non-cardiac event group.During the same period, 157 subjects of physical examination were selected as the control group.The expression level of serum miR-139-3p, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), serum B-type brain natriuretic peptide (BNP) level, and serum troponin Ⅰ (cTnⅠ) level were detected.Pearson method was used to analyze the correlation between serum miR-139-3p level and cardiac function indexes in elderly patients with chronic heart failure.ROC curve was used to analyze serum miR-139-3p level in predicting prognosis of elderly patients with chronic heart failure.
      Results Compared with the control group, the observation group had higher proportions of hypertension, hyperlipidemia, levels of miR-139-3p, LVEDD, BNP cTnI, TG, TC, LDL-C, and lower LVEF level (P < 0.01).The serum miR-139-3p level in elderly patients with chronic heart failure was positively correlated with LVEDD, BNP and cTnI (r=0.504, 0.498, 0.492, P < 0.01), and negatively correlated with LVEF (r=-0.519, P < 0.01).The level of serum miR-139-3p in elderly patients with chronic heart failure with heart function grade Ⅱ, grade Ⅲ and grade Ⅳ increased in turn (P < 0.01).Compared with the non-cardiac event group, the miR-139-3p level, age, hypertension ratio, LVEDD, BNP and cTnI in the cardiac event group was higher, LVEF was lower (P < 0.01).The AUC of serum miR-139-3p in predicting cardiac events in elderly patients with chronic heart failure was 0.849(95%CI: 0.788-0.910), the cutoff value was 2.98, the sensitivity was 81.8%, and the specificity was 76.3%.
      Conclusions The detection of serum miR-139-3p level can provide evidence for the treatment and prognosis of elderly patients with chronic heart failure.

       

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