微小RNA-133a在缺血性心力衰竭患者血清中的表达及意义

目的探讨缺血性心力衰竭患者血清微小RNA-133a(micro RNA-133a,miR-133a)表达浓度与心力衰竭各指标的关系及其临床应用价值。方法选取2018年1月至2019年9月在沈阳市第四人民医院确定诊断为缺血性心力衰竭的80例患者临床资料进行前瞻性分析,根据美国纽约心脏病协会(New York Heart Association,NYHA)分级分为NYHAⅠ级组、Ⅱ级组、Ⅲ级组、Ⅳ级组各20例,选取同期健康体检者20名为健康对照组,采用全自动免疫分析仪检测外周血脑钠肽(brain natriuretic peptide,BNP)浓度,采用超声心动图检测心功能各项指标,采用qRT-PCR检测血清miR-133a表达,比较不同心功能分级miR-133a表达浓度差异,对miR-133a与BNP浓度及超声心动图指标相关性进行分析。结果血清miR-133a表达在健康对照组(0.167±0.024)、NYHAⅠ级组(0.289±0.012)、NYHAⅡ级组(0.415±0.034)、NYHAⅢ级组(0.981±0.217)、NYHAⅣ级组(1.238±0.249)之间比较,差异有统计学意义(F=106.4,P<0.001);Pearson相关分析显示,miR-133a在NYHAⅡ、Ⅲ、Ⅳ级别中表达浓度均与BNP浓度呈现正相关性(r=0.815,95%CI:0.582~0.924,P<0.001;r=0.465,95%CI:0.029~0.753,P<0.05;r=0.749,95%CI:0.459~0.895,P<0.001)。miR-133与射血分数值为负相关(r=-0.811,95%CI:-0.875^-0.719,P<0.001),与左心室后壁厚度值为正相关(r=0.331,95%CI:0.120~0.513,P<0.01),与左心室内径值为正相关(r=0.845,95%CI:0.764~0.896,P<0.001),与舒张末期容积值为正相关(r=0.705,95%CI:0.572~0.803,P<0.001)。结论缺血性心力衰竭患者miR-133a表达浓度升高,并与心功能不良指标具有相关性,具有一定的诊断及预后判断价值。

Expression and significant of microRNA-133a expression in ischemic heart failure patients serum

Objective To explore the relationship between the expression level of micro RNA-133a(miR-133a)and the indexes of heart failure in patients with ischemic heart failure and its clinical application value.Methods From January 2018 to September 2019,the clinical data of 80 patients diagnosed as ischemic heart failure in Shenyang Fourth People′s Hospital were analyzed prospectively.According to the classification of New York Heart Association(NYHA),20 cases were divided into NYHA classⅠgroup,classⅡgroup,classⅢgroup and classⅣgroup,and 20 healthy people in the same period were selected as the healthy control group.The concentration of brain natriuretic peptide(BNP)in peripheral blood was detected by automatic immune analyzer,the indexes of cardiac function were detected by echocardiography,the expression of miR-133a in serum was detected by qRT-PCR,the difference of expression concentration of miR-133a in different functional grades was compared,and the correlation between the concentration of miR-133a and BNP and the indexes of echocardiography was analyzed.Results The expression of miR-133a in healthy control group(0.167±0.024),NYHAⅠgroup(0.289±0.012),NYHAⅡgroup(0.415±0.034),NYHAⅢgroup(0.981±0.217)and NYHAⅣgroup(1.238±0.249)was statistically significant(F=106.4,P<0.001).Pearson correlation analysis showed that miR-133a was positively correlated with BNP in NYHAⅡ,ⅢandⅣgrade(r=0.815,95%CI:0.582-0.924,P<0.001;r=0.465,95%CI:0.029-0.753,P<0.05;r=0.749,95%CI:0.459-0.895,P<0.001).MiR-133 was negatively correlated with EF(r=-0.811,95%CI:-0.875--0.719,P<0.001),positively correlated with LVPW,LV and EDV(r=0.331,95%CI:0.120-0.513,P<0.01;r=0.845,95%CI:0.764-0.896,P<0.001;r=0.705,95%CI:0.572-0.803,P<0.001).Conclusion The expression of miR-133a in patients with ischemic heart failure is increased,which is related to the index of cardiac dysfunction,and has certain diagnostic and prognostic value.