冠状动脉粥样硬化性心脏病慢性心力衰竭患者 血清microRNA-499 水平及与心功能 和心肌重构的相关性

Serum microRNA-499 level in patients with coronary atherosclerotic heart disease and its relationship with cardiac function and myocardial remodeling

摘要:

目的 探究冠状动脉粥样硬化性心脏病（以下简称冠心病）慢性心力衰竭（CHF）患者血清 microRNA-499（miR-499）水平及与心功能和心肌重构的关系，探讨其在CHF 中的临床价值。方法 选择 2016 年1 月—2018 年12 月在大连市第三人民医院心内科就诊的冠心病CHF 患者90 例作为CHF 组，同期该 院健康体检者90 例为对照组。测定血清miR-499 水平。测定研究对象心功能指标：左室射血分数（LVEF）、 心输出量（CO），以及心肌重构指标：左心房内径（LAP）、左室舒张末内径（LVEDD）、左室后壁厚度（LVPW）、 左室重构指数（LVRI）、左室质量指数（LVMI）。结果 CHF 组血清miR-499 水平高于对照组（P <0.05）， LVEF、CO、LVRI 低于对照组（P <0.05），LAP、LVEDD、LVPW、LVMI 高于对照组（P <0.05）。不同心 功能分级患者的血清miR-499 水平及LVEF、CO、LAP、LVPW、LVRI、LVMI 比较，差异均有统计学意义 （P <0.05），随心功能分级升高，血清miR-499 水平升高，LVEF、CO、LVRI 降低，LAP、LVPW、LVMI 升高。 CHF 患者血清miR-499 水平与LVEF、CO、LVRI 呈负相关（P <0.05），与LAP、LVPW、LVMI 呈正相关 （P <0.05）。结论 miR-499 在冠心病CHF 患者血清中升高，与患者病情严重程度、心功能和心肌重构关系 密切。

Abstract:

Objective To investigate the serum miR-499 level in patients with coronary heart disease Chronic heart failure(CH) and its relationship with cardiac function and myocardial remodeling in order to explore its clinical value in CHF. Methods From January 2016 to December 2018, 90 patients with coronary heart disease CHF were enrolled as the CHF group, and 90 healthy subjects were selected as the control group (C group) in the Department of Cardiology of Third People’s Hospital of Dalian. The serum miR-499 levels were determined.The cardiac function indexes, containing left ventricular ejection fraction (LVEF) and cardiac output (CO), and myocardial remodeling indexes including left atrial inner diameter (LAP), left ventricular end diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPW), left ventricular remodeling index (LVRI) and left ventricular mass index (LVMI) were determined. Results The levels of serum miR-499 in CHF group were higher than those in C group (P < 0.05);LVEF,CO and LVRI were lower than those in group C (P < 0.05); LAP,LVEDD,LVPW and LVMI were higher than those in C group (P < 0.05). Comparing serum miR-499 levels and LVEF, CO, LAP, LVPW, LVRI, LVMI in patients with different cardiac function grading between the two groups, the differences were statistically significant (P < 0.05). With the increase of cardiac function classification, serum miR-499 levels increased, LVEF, CO and LVRI decreased, and LAP, LVPW and LVMI increased. Serum miR-499 levels were negatively correlated with LVEF, CO and LVRI in CHF patients (P < 0.05), and positively correlated with LAP, LVPW and LVMI (P < 0.05). Conclusion MiR-499 is elevated in the serum of coronary heart disease patients with CHF, and is closely related to the severity of the disease, cardiac function and myocardial remodeling.