左心疾病患者血清微小RNA-206水平与肺动脉高压的关系

目的探讨左心疾病(LHD)患者血清微小RNA-206(miR-206)水平与肺动脉高压(PH)的关系。方法选取2016年3月-2017年3月我院收治的103例LHD患者,根据是否合并PH分为LHD合并PH组(47例)和LHD未合并PH组(56例),同期选取50例体检健康者作为对照组,采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清miR-206水平,分析其与肺动脉高压及心功能之间的相关性。结果对照组、LHD未合并PH组和LHD合并PH组年龄、性别、吸烟史、舒张压(DBP)、心率比较,差异均无统计学意义(P>0.05),BMI、收缩压(SBP)、美国纽约心脏病学会(NYHA)心功能分级、肺动脉收缩压(PASP)、左心房纵径(LAD)、左心室舒张末期内径(LVEDD)、右心房直径(RAD)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)和脑钠肽(BNP)水平比较,差异有统计学意义(P<0.05)。与对照组、LHD未合并PH组比较,LHD合并PH组血清miR-206水平明显降低(P<0.05),LHD未合并PH组患者与对照组血清miR-206水平比较,差异无统计学意义(P>0.05)。Spearman相关分析结果显示,血清miR-206水平与PASP、LVEDD呈负相关(r=-0.512、-0.461,P<0.05),与LVEF呈正相关(r=0.534,P<0.05).单因素相关分析结果显示,NYHA分级.miR-206.BNP、LAD、LVEDD、RAD、RVD、LVEF与PH显著相关(P<0.05).多因素logistic回归分析结果显示,miR.206、BNP、LAD是影响LHD患者合并PH发生的独立预测因子°结论血清miR-206水平降低与LHD患者PASP增加有关,血清miR-206是影响LHD患者合并PH发生的独立预测因子。

Relationship between serum microRNA-206 level and pulmonary hypertension in patients with left heart disease

Objective To investigate the relationship between serum microRNA-206 ( miR-206) level and pulmonary hypertension( PH) in patients with left heart disease(LHD). Methods A total of 103 LHD patients in our hospital from March 2016 to March 2017 were selected as the study subjects. According to whether combined with PH,they were divided into two groups,LHD combined with PH group(47 cases) and LHD without combined PH group(56 cases). In the same period,50 healthy subjects were selected as control group. Serum miR-206 level was detected by quantificational real-time polymerase chain reaction (qRT-PCR). The correlation among serum miR-206 level and pulmonary hypertension, cardiac function were analyzed. Results There were no significant differences in age, sex, smoking history, diastolic blood pressure(DBP) and heart rate( HR) between the three groups(P >0.05),BMI,systolic blood pressure(SBP), New York Heart Association ( NYHA) cardiac functional classification, pulmonary artery systolic pressure (PASP), left atriallongitudinal diameter ( LAD), left ventricular end-diastolic dimension ( LVEDD ), right atrial diameter( RAD),left ventricular ejection fraction( LVEF),left ventricularfraction shortening( LVFS) and brain natriuretic peptide(BIVP) were statistically significant (P < 0. 05). Compared with healthy control group and LHD without PH group, serum miR-206 level in LHD combined with PH group was significantly lower( P <0.05). There was no significant difference in the level of serum miR-206 between LHD without PH group and healthy control group (P > 0. 05). Spearman correlation analysis showed that serum miR-206 level was negatively correlated with PASP and LVEDD(r =-0.512,-0.461 <0.05),and positively correlated with LVEF ( r = 0. 534, P < 0. 05 ). Univariate analysis showed that there was a significant correlation between NYHA classification, miR-206, BNP, LAD, LVEDD, RAD, RVD and LVEF and PH (P<0.05). Logistic regression analysis showed that miR-206, BNP and LAD were independent predictors of PH in patients with LHD. Conclusion Decreased serum levels of miR-206 are associated with increased PASP in patients with LHD,and serum miR-206 was an independent predictor of PH in patients with LHD.