循环miR-130a表达与慢性心力衰竭患者心功能及中医证型的相关性分析

目的探讨miR-130a表达水平与慢性心力衰竭患者心功能及中医证型的相关性。方法选取2018年8月—2020年8月郑州市中医院心内科收治的慢性心力衰竭患者184例,参照美国心脏协会心功能(NYHA)分级将患者分为Ⅰ级、Ⅱ级67例,Ⅲ级60例,Ⅳ级57例。根据辨证分型标准将患者分为心气虚型32例,气阴两虚型50例,气虚痰瘀型61例,心肾阳虚型41例。利用荧光实时定量PCR(qRT-PCR)检测受试者血清中miR-130a表达水平。采用超声诊断仪检测所有研究对象左室舒张内径(LVDD),左室射血分数(LVEF)。分析慢性心力衰竭患者miR-130a表达水平与心功能指标LVDD、LVEF以及中医辨证分型的相关性,并探讨中医辨证分型与心功能分析的关系。结果与Ⅰ、Ⅱ级相比,心功能Ⅲ级、Ⅳ级患者miR-130a表达水平、LVDD值较高,LVEF值较低(P <0.05);与Ⅲ级相比,心功能Ⅳ级患者miR-130a表达水平、LVDD值较高,LVEF值较低(P <0.05)。心功能LVDD值与miR-130a水平呈正相关,心功能LVEF值与miR-130a水平呈负相关(P <0.05)。心气虚型、气阴两虚型、气虚痰瘀型、心肾阳虚型患者血清miR-130a水平依次升高。结论血清miR-130a水平与慢性心力衰竭患者心功能及中医证型密切相关,为心功能分级、中医证型分型提供了理论基础。

Analysis on the Correlations between the Expression of miR-130a in Circulation and the Heart Function,Traditional Chinese Medicine Syndromes in Patients with Chronic Heart Failure

Objective To explore the correlation between the expression level of miR-130 a and the heart function and traditional Chinese medicine( TCM) syndrome types in patients with chronic heart failure. Methods From August 2018 to August 2020,184 patients with chronic heart failure were enrolled in the department of cardiology of Zhengzhou Hospital of Traditional Chinese Medicine. According to the New York Heart Association( NYHA),the patients were divided into 67 patients of grade Ⅰ and Ⅱ,60 patients of grade Ⅲ and 57 patients of grade Ⅳ. According to the standard of syndrome differentiation,the patients were divided into 32 cases of heart qi type,50 cases of deficiency of both qi and yin type,61 cases of qi deficiency and phlegm stasis type,and 41 cases of deficiency of heart and kidney yang type. The expression of miR-130 a in serum was detected by real-time quantitative PCR( qRT-PCR). The left ventricular diastolic diameter( LVDD) and left ventricular ejection fraction( LVEF) were measured by ultrasound. The correlations between the expression level of miR-130 a and LVDD,LVEF,TCM syndrome differentiation were analyzed,and the relationship between TCM syndrome differentiation and cardiac function analysis was explored. Results The expression level of miR-130 a and LVDD in patients with grade Ⅲ and Ⅳ cardiac function were higher than those in grade Ⅰ and Ⅱ,and LVEF was lower( P < 0. 05). Compared with grade Ⅲ,the expression level of miR-130 a and LVDD in grade Ⅳ patients were higher,and LVEF was lower( P < 0. 05). LVDD of cardiac function was positively correlated with miR-130 a,and there was a negative correlation between LVEF and miR-130 a( P < 0. 05). The level of serum miR-130 a in patients with deficiency of heart qi type,deficiency of both qi and yin type,qi deficiency and phlegm stasis type,and deficiency of heart and kidney yang type increased in turn. Conclusion The level of serum miR-130 a is closely related to the heart function and TCM syndrome types of patients with chronic heart failure,which provides a theoretical basis for the cardiac function grading and TCM syndrome classification.