缺血性心肌病患者血浆miR-21和miR-214的表达及其意义-东南大学学报医学版

缺血性心肌病患者血浆miR-21和miR-214的表达及其意义

单位：江汉大学附属医院心血管内科, 湖北武汉 430016

分类号：R542.2

出版年·卷·期（页码）：2017·36·第二期（136-141）

摘要：

目的：探讨缺血性心肌病（ICM）患者血浆miR-21和miR-214的表达及其意义。方法：选取2015年1月至2016年1月我院收治的ICM患者和同期体检健康的志愿者各33例，检测血浆miR-21和miR-214表达水平、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、舒张压（DBP）、收缩压（SBP）、N末端B型脑钠肽原（NT-proBNP）、左心室舒张末期内径（LVEDd）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）。分析ICM患者miR-21及miR-214水平与各指标的相关性，采用受试者工作特征曲线（ROC曲线）评价其对ICM的诊断价值。结果：ICM组与对照组TC、TG、DBP及SBP比较差异无统计学意义（P>0.05）；ICM组HDL-C、LVEF低于对照组，而LDL-C、NT-proBNP、LVEDd、LVEDV及LVESV高于对照组（P<0.05）；ICM组miR-21及miR-214表达水平较对照组显著上调（P<0.001）。ICM患者miR-21及miR-214水平与NT-proBNP、LVEDd、LVEDV、LVESV呈正相关（P<0.05），与LVEF呈负相关（P<0.05）。二者联合诊断的ROC曲线下面积（AUC，为0.865）、灵敏度（87.5%）和特异度（78.3%）均大于单独诊断（P<0.05）。结论：ICM患者血浆miR-21和miR-214表达升高，且与NT-proBNP、LVEDd、LVEDV及LVESV呈正相关，与LVEF呈负相关，可能参与了ICM患者心室重构过程。联合检测对ICM有较好的诊断效能，或可作为临床上鉴别诊断ICM的生物标志物。

Objective: To investigate the expression of plasma miR-21 and miR-214 in patients with ischemic cardiomyopathy (ICM) and its significance. Methods: 33 ICM patients (ICM group) and 33 healthy volunteers (control group) in our hospital from January 2015 to January 2016 were selected. Clinical data of plasma miR-21 and miR-214 levels, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), diastolic blood pressure (DBP), systolic blood pressure (SBP), N-terminal-pro-B-type natriuretic peptide (NT-proBNP), left ventricular end diastolic diameter (LVEDd), left ventricular diastolic end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection ejection fraction (LVEF) were collected. The correlation between miR-21, miR-214 levels and above indicators were analyzed. The diagnostic value of miR-21 and miR-214 on ICM patients were evaluated by receiver operating curve (ROC). Results: There was no significant difference in TC, TG, DBP and SBP between ICM group and control group (P>0.05). The levels of HDL-C, LVEF were lower, while the LDL-C, NT-proBNP, LVEDd, LVEDV and LVESV were higher in ICM group than those in control group (P<0.05). The expression levels of miRNA-21 and miRNA-214 in ICM group were significantly higher than those in control group (P<0.001). miR-21 and miR-214 levels in ICM patients were positively correlated with NT-proBNP, LVEDd, LVEDV and LVESV (P<0.05), and were negatively correlated with LVEF (P<0.05). The AUC (0.865), sensitivity (87.5%) and specificity (78.3%) of combined diagnosis were higher than separate diagnosis (P<0.05). Conclusion: The levels of plasma miR-21 and miR-214 significantly increase in ICM patients. Plasma miR-21 and miR-214 are positively correlated with NT proBNP, LVEDd, LVEDV and LVESV, and negatively correlated with LVEF, which may be involved in the process of ventricular remodeling in ICM patients. Combined diagnosis has better diagnostic performance, they may be used as biomarkers for ICM diagnosis.

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