摘要
目的:探讨扩张型心肌病(DCM)血清微小核糖核酸(mi R)-210、β2微球蛋白(β2-MG)及转化生长因子-β1(TGF-β1)水平特点,分析其诊断DCM以及预测DCM预后的价值。方法:选择2016年8月至2018年8月我院收治的105例DCM患者(DCM组),同期63例健康体检者(对照组),根据随访期间是否发生心源性死亡将DCM患者分为生存组(76例)与死亡组(29例)。检测血清mi R-210、β2-MG、TGF-β1表达水平、超声心动图指标及其它实验室指标水平,Pearson分析DCM患者血清mi R-210,β2-MG及TGF-β1与超声心动图和其它实验室指标之间相关性,受试者工作特征(ROC)曲线分析mi R-210、β2-MG及TGF-β1诊断DCM以及预测DCM预后的价值。结果:DCM组血清mi R-210、β2-MG、TGF-β1、高敏C反应蛋白(hs-CRP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)、B型脑钠肽(BNP)水平,左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、E峰至室间隔距离(EPSS)、收缩末期容积(LVESV)高于对照组(P<0.05),左心室射血分数(LVEF)低于对照组(P<0.05)。死亡组血清mi R-210、β2-MG及TGF-β1水平高于生存组(P<0.05)。DCM患者血清mi R-210、β2-MG及TGF-β1水平与CK-MB、cTnI、BNP、LVEDD、LVEDV、EPSS、LVESV呈正相关(P<0.05),与LVEF呈负相关(P<0.05),TGF-β1与hs-CRP呈正相关(P<0.05)。mi R-210、β2-MG及TGF-β1诊断DCM、预测DCM预后的曲线下面积(AUC)分别为0.600、0.639、0.615;0.628、0.632、0.634,联合三项指标诊断DCM、预测DCM预后的AUC为0.885、0.863。结论:DCM患者血清mi R-210、β2-MG、TGF-β1水平均增高,且与左心重构、心肌损伤以及预后不良有关,可作为DCM诊断以及预后预测的辅助指标。
Objective:To investigate the levels of serum microRNA(mi R)-210,β2 microglobulin(β2-MG)and transforming growth factor-β1(TGF-β1)in dilated cardiomyopathy(DCM),and to analyze its value in diagnosing DCM and predicting the prognosis of DCM.Methods:From August 2016 to August 2018,105 cases of DCM patients(DCM group)who were treated in our hospital and 63physical examination volunteers(control group)were selected.DCM patients were divided into survival group(76 cases)and death group(29 cases)according to whether cardiogenic death occurred during follow-up.Serum mi R-210,β2-MG and TGF-β1 expression levels,echocardiographic indexes and other laboratory indexes were detected.Pearson analyzed the correlation between mi R-210,β2-MG and TGF-β1 and echocardiography and other laboratory indexes.Receiver operating characteristic(ROC)curve analysis mi R-210,β2-MG and TGF-β1 the value of diagnosing DCM and predicting the prognosis of DCM.Results:The mi R-210,β2-MG,TGF-β1,high sensitivity C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),troponin I(cTnI),B-type brain natriuretic peptide(BNP)levels,left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),E peak to ventricular septal distance(EPSS)and left ventricular end systolic volume(LVESV)in DCM group were higher than those in control group(P<0.05),and left ventricular ejection fraction(LVEF)was lower than that in control group(P<0.05).The serum mi R-210 andβ2-MG and TGF-β1 levels in the death group were higher than those in the survival group(P<0.05).The serum mi R-210,β2-MG and TGF-β1 levels of DCM patients were positively correlated with CK-MB,cTnI,BNP,LVEDD,LVEDV,EPSS and LVESV(P<0.05),and negatively correlated with LVEF(P<0.05).TGF-β1 was positively correlated with hs-CRP(P<0.05).The areas under the curve(AUC)of mi R-210,β2-MG and TGF-β1 for diagnosing DCM and predicting prognosis of DCM were 0.600,0.639,0.615 and 0.628,0.632,0.634,the AUC of DCM diagnosis and prognosis prediction combined with the three indexes were 0.885 and 0.863(P<0.05).Conclusion:The serum mi R-210,β2-MG and TGF-β1 levels of DCM patients are increased,which is associated with left heart remodeled,myocardial injury and poor prognosis,and can be used as auxiliary indexes of DCM diagnosis and prognosis prediction.
作者
冯莉莉
王朝华
李贺
徐勤
张臣
FENG Li-li;WANG Zhao-hua;LI He;XU Qin;ZHANG Che(Department of Cardiology,Brains Hospital of Hunan Province,Changsha,Hunan,410007,China)
出处
《现代生物医学进展》
CAS
2022年第4期688-692,717,共6页
Progress in Modern Biomedicine
基金
湖南省卫生计生委科研基金项目(C2016018)。
