摘要
目的探讨循环外泌体中miR-92b-5p的表达水平对射血分数降低的心力衰竭(HFrEF)患者的诊断和预测价值。方法选择于2018年1月至2019年7月化州市人民医院心血管内科经确诊为心力衰竭(HF)的患者共74例,其中HFrEF患者33例(HFrEF组),非HFrEF患者41例(HF组),选取40名健康体检者作为对照组,检测各组人群血清循环外泌体miR-92b-5p的表达水平,分析外泌体miR-92b-5p表达水平与超声心动图指标的关系,ROC曲线分析外泌体miR-92b-5p对HFrEF患者的诊断价值。结果 HFrEF组的外泌体中miR-92b-5p表达水平以及脑钠肽(BNP)、左心房直径(LAD)、左心室舒张期直径(LVDD)、左心室收缩末期直径(LVSD)水平显著高于HF组和对照组,差异有统计学意义(P<0.001);而左心室射血分数(LVEF)、左心室缩短分数(LVFS)显著低于HF组和对照组,差异有统计学意义(P<0.001)。血清外泌体miR-92b-5p表达水平与BNP、LAD、LVDD、LVSD呈显著正相关(r=0.489、0.446、0.469、0.414),与LVEF和LVFS呈显著负相关(r=-0.505、-0.512),差异有统计学意义(P<0.001)。外泌体miR-92b-5p对HFrEF的诊断ROC曲线下面积为0.905,当miR-92b-5p表达水平为6.49时,其敏感度为93.9%,特异度为77.8%。结论循环外泌体miR-92b-5p表达水平在HFrEF患者中显著上升,且与心功能密切相关,是诊断HFrEF的良好临床生物标记物。
Objective To investigate the diagnostic and predictive value of miR-92 b-5 p expression in circulating exosomes in patients with heart failure with reduced ejection fraction(HFrEF). Methods A total of 74 patients with heart failure(HF)diagnosed in department of cardiovascular medicine of the Huazhou People’s Hospital from January 2018 to July 2019 were enrolled,including 33 patients with HFrEF(HFrEF group)and 41 patients with non-HFrEF(HF group). 40 healthy participants were selected as control group. Serum exosomes of all participants were extracted,and the expression level of miR-92 b-5 p was detected. The relationship between the expression level of exosome miR-92 b-5 p and echocardiographic index was analyzed,and the ROC curve was used to analysis of the diagnostic value of exosome miR-92 b-5 p in patients with HFrEF. Results The expression level of miR-92 b-5 p in circulating exosomes and brain natriuretic peptide(BNP),left atrial diameter(LAD),left ventricular diastolic diameter(LVDD),and left ventricular end-systolic diameter(LVSD)levels in the HFrEF group were significantly higher than that in the HF group and the control group,the difference was statistically significant(P<0.001);while the left ventricular ejection fraction(LVEF) and left ventricular fraction shortening(LVFS) were significantly lower than that in the HF group and the control group,and the difference was statistically significant(P<0.001). The expression levels of serum exosome miR-92 b-5 p were significantly positively correlated with BNP,LAD,LVDD and LVSD(r=0.489,0.446,0.469,0.414),and significantly negatively correlated with LVEF and LVFS(r=-0.505,-0.512). The ROC curve of exosome miR-92 b-5 p on HFrEF had a value of 0.905. When the expression level of miR-92 b-5 p was 6.49,the sensitivity was 93.9% and the specificity was 77.8%. Conclusions The expression of miR-92 b-5 p in circulating exosomes was significantly increased in patients with HFrEF,and was closely related to cardiac function. The circulating exosome miR-92 b-5 p could be a good clinical biomarker for the diagnosis of HFrEF.
作者
杨鸣宇
何航宇
李康荣
YANG Ming-yu;HE Hang-yu;LI Kang-rong(Department of Cardiovascular Medicine,Huazhou People's Hospital,Huazhou,Guangdong 525100,China)
出处
《热带医学杂志》
CAS
2021年第6期777-781,共5页
Journal of Tropical Medicine
