摘要
目的探讨老年急性心力衰竭患者血清miR-181b表达与心功能指标及预后的关系。方法选择2015年11月至2017年11月收治的86例老年急性心力衰竭患者作为观察组,并根据纽约心脏学会(NYHA)分级的不同分为Ⅱ级组26例、Ⅲ级组32例、Ⅳ级组28例。选择同期健康体检人群40例为对照组。采用qRT-PCR检测研究对象血清miR-181b水平表达量。比较不同组血清miR-181b水平以及心功能指标关系的关系,并采用Logistic回归分析探讨血清miR-181b表达水平与老年急性心力衰竭患者随访1年的预后关系。结果血清BNP、LVEF比较差异有统计学意义(P<0.05);4组血清miR-181b水平比较差异均有统计学意义(P<0.05),心功能Ⅳ级组的血清miR-181b水平表达明显低于心功能Ⅱ级组、心功能Ⅲ级组、对照组(心功能Ⅳ级组<心功能Ⅲ级组<心功能Ⅱ级组<对照组,P<0.01);血清miR-181b水平与血清脑钠肽(BNP)呈负相关(r=-0.654,P=0.001);血清miR-181b水平与血清LVEF呈正相关(r=0.467,P=0.001);所有患者经过1年随访,其中24例患者发生不良结果,其血清miR-181b水平明显低于非不良事件患者(P<0.05);Logistic回归分析表示,血清BNP≥200 pg/L(OR=3.50,95%CI:2.63~4.67)、LVEF≤50%(OR=3.08,95%CI:1.92~4.94)、miR-181b≤19.28(OR=4.26,95%CI:1.92~5.46)为急性心力衰竭患者预后良好的危险因素。结论血清miR-181b水平在急性心力衰竭患者中的表达水平降低,且在预后不良患者中表达水平降至更低,因此血清miR-181b水平与急性心力衰竭患者的预后有重要关系。
Objective To investigate the correlation between the expression of miR-181b and cardiac function indexes as well as prognosis of elderly patients with acute heart failure.Methods A total of 86 elderly patients with acute heart failure who were admitted and treated in our hospital from November 2015 to November 2017 were enrolled as observation group,and 40 healthy subjects who underwent physical examination in our hospital were enrolled as control group.The observation group was redivided into three subgroups according to the New York Heart Association(NYHA)classification,namely,gradeⅡgroup(n=26),gradeⅢgroup(n=32)and gradeⅣgroup(n=28).The expression levels of serum miR-181b were measured by qRT-PCR,and its correlation with the cardiac function index and prognosis after 1-year follow up was analyzed.Results There were significant differences in the serum levels of BNP and LVEF among the four groups(P<0.05).there were significant differences in the serum levels of miR-181b among the four groups(P<0.05).The serum levels of miR-181b were in order(from high to low)gradeⅣgroup,gradeⅢgroup,gradeⅡgroup and control group(P<0.01).Moreover the serum levels of miR-181b were negatively correlated with those of BNP(P<0.01),which were positively correlated with those of LVEF(P<0.01).In addition 24 patients had adverse reactions after 1-year follow up,and the serum levels of miR-181b in patient with adverse reactions were significantly lower than those of patients without adverse reactions(P<0.05).Logistic regression analysis showed that serum BNP≥200pg/L,LVEF≤50%,miR-181b≤19.28 were the risk factors for patients with acute heart failure.Conclusion The serum levels of miR-181b are decreased in patients with acute heart failure,and its expression levels are even lower in patients with poor prognosis,therefor,the serum miR-181b levels are losely correlated with the prognosis of patients with acute heart failure.
作者
黄如彬
王利莎
丁力
HUANG Rubin;WANG Lisha;DING Li(Department of Geriatric General Medicine,Jiangjin District Central Hospital of Chongqing City,Chongqing 402260,China)
出处
《河北医药》
CAS
2019年第22期3448-3450,3454,共4页
Hebei Medical Journal
基金
重庆市卫生计生委科研基金项目(编号:2016MSXM149)
