心肌梗死后心力衰竭患者血清microRNA-155 表达水平及其临床意义

Expression of serum miR-155 and its clinical significance in patients with heart failure after myocardial infarction

摘要:

目的 探讨心肌梗死后心力衰竭患者血清microRNA-155（miR-155）表达水平及临床意义。 方法 选择陈旧性心肌梗死后心力衰竭患者作为心力衰竭组，陈旧性心肌梗死无心力衰竭患者作为心肌梗死 组，健康体检者作为对照组，每组80 例。采用逆转录聚合酶链反应（RT-PCR）测定血清miR-155 水平。 采用超声心动图测定左心室射血分数（LVEF）、左室后壁厚度（LVPW）及左室舒张末期内径（LVEDD）。 结果 心力衰竭组患者血清miR-155 水平高于对照组和心肌梗死组（P <0.05）；心肌梗死组患者血清miR- 155 水平高于对照组（P <0.05）。血清miR-155 诊断心肌梗死后心力衰竭的ROC 曲线下面积为0.921（95% CI ：0.842，0.963），临界值为1.670，敏感性为88.73%（95% CI ；0.375，0.964），特异性为92.14%（95% CI ： 0.792，0.976）。miR-155 高表达组和miR-155 低表达组患者年龄、性别、空腹血糖、高密度脂蛋白胆固醇、 低密度脂蛋白胆固醇、肌酐及甘油三酯比较，差异无统计学意义（P >0.05）。miR-155 高表达组患者氨基末 端脑钠肽前体水平高于miR-155 低表达组（P <0.05）；miR-155 高表达组LVEF 低于miR-155 低表达组 （P <0.05），而LVEDD 高于miR-155 低表达组（P <0.05），两组LVPW 比较，差异无统计学意义（P >0.05）。 miR-155 高表达组心功能Ⅲ、Ⅳ级患者比例高于miR-155 低表达组（P <0.05）。结论 心肌梗死后心力衰 竭患者血清miR-155 水平升高，对评估病情严重程度具有重要意义。

Abstract:

Objective To investigate the expression and clinical significance of serum miR-155 in patients with heart failure after staleness myocardial infarction. Methods Eighty patients with heart failure after staleness myocardial infarction were enrolled as heart failure group, 80 patients with myocardial infarction without heart failure were enrolled as myocardial infarction group, and 80 healthy residents were enrolled as control group. The level of serum miR-155 was determined by reverse transcription-polymerase chain reaction (RT-PCR). The left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness (LVPW) and left ventricular end diastolic diameter (LVEDD) were measured by echocardiography. Results The levels of serum miR-155 in the heart failure group were higher than those in the control group and the myocardial infarction group (P < 0.05). The levels of serum miR- 155 in the myocardial infarction group were higher than those in the control group (P < 0.05). The area under the ROC curve of serum miR-155 for diagnosis of heart failure after myocardial infarction was 0.921 (95% CI: 0.842, 0.963), the critical value was 1.67, the sensitivity was 88.73% (95% CI: 0.375, 0.964), and the specificity was 92.14% (95% CI: 0.792, 0.976). There was no significant difference in the age, sex, fasting blood glucose (FPG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine (Cr) and triglyceride (TG) between the miR-155 high expression group and the miR-155 low expression group (P > 0.05). The level of amino-terminal pro-brain natriuretic peptide (NT-proBNP) in the miR-155 high expression group was higher than that in the miR-155 low expression group (P < 0.05). The LVEF of the miR-155 high expression group was lower than that of the miR-155 low expression group (P < 0.05), while the LVEDD was higher than that of the miR-155 low expression group (P < 0.05). There was no significant difference in LVPW between the two groups (P > 0.05). The proportion of patients with heart function ranged III to IV in the miR-155 high expression group was higher than that in the miR-155 low expression group (P < 0.05). Conclusions The serum miR-155 level is elevated in patients with heart failure after myocardial infarction. It is of great significance in the assessment of cardiac function and severity of heart failure after myocardial infarction.