慢性心力衰竭合并肺炎支原体感染外周血miRNA-21/PTEN表达与心肌损伤和预后的关系  

Relationship between expressions of peripheral blood miRNA-21/PTEN and myocardial injury and prognosis of chronic heart failure patients complicated with Mycoplasma pneumoniae infection

作　　者：李延芳 顾方方[1] 闵国美[1] 汤彩虹 沈琳燕 潘利海 LI Yan-fang;GU Fang-fang;MIN Guo-mei;TANG Cai-hong;SHEN Lin-yan;PAN Li-hai(Huzhou Central Hospital(Affiliated Central Hospital of Huzhou Normal University),Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市中心医院(湖州师范学院附属中心医院)心内科,浙江湖州313000

出　　处：《中华医院感染学杂志》2022年第22期3386-3390,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2018RC069)。

摘　　要：目的分析慢性心力衰竭(CHF)合并肺炎支原体(MP)感染患者外周血微小RNA-21(miRNA-21)/蛋白酪氨酸磷酸酶基因(PTEN)表达与心肌损伤、预后的关系。方法选取2019年6月-2021年6月湖州师范学院附属中心医院CHF患者,根据是否合并MP感染分为MP感染组70例、非MP感染组110例。比较两组外周血miRNA-21、PTEN mRNA,血清心肌损伤标志物[肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)、谷草转氨酶(AST)]水平,采用Pearson相关性分析外周血miRNA-21、PTEN mRNA与心肌损伤标志物的关系;MP感染组患者根据3个月内主要心血管不良事件(MACE)发生情况进一步分为预后不良组、预后良好组,比较两组外周血miRNA-21、PTEN mRNA表达水平,分析其对患者不良预后的预测效能。结果MP感染组外周血miRNA-21、PTEN mRNA相关表达量及血清CK-MB、LDH、cTnI、AST水平均高于非MP感染组(P<0.05);Pearson相关性分析显示,外周血miRNA-21、PTEN mRNA相对表达量与血清CK-MB、LDH、cTnI、AST水平均呈正相关(P<0.05);预后不良组外周血miRNA-21、PTEN mRNA相对表达量高于预后良好组(P<0.05);受试者工作特征曲线(ROC)显示,外周血miRNA-21、PTEN mRNA相对表达量联合检测对CHF合并MP感染患者不良预后具有较高预测价值(P<0.05)。结论CHF合并MP感染患者伴随外周血miRNA-21及PTEN mRNA表达上调,且二者表达水平与心肌损伤密切相关,可联合预测不良预后。OBJECTIVE To observe the relationship between the expressions of peripheral blood microRNA-21(miRNA-21)/protein tyrosine phosphatase gene(PTEN)and the myocardial injury and prognosis of chronic heart failure(CHF)patients complicated with Mycoplasma pneumoniae(MP)infection.METHODS The patients with CHF who were treated in Affiliated Central Hospital of Huzhou Normal University from Jun 2019 to Jun 2021 were enrolled in the study and divided into the MP infection group with 70 cases and the non-MP infection group with 110 cases.The levels of peripheral blood miRNA-21,PTEN mRNA,serum markers of myocardial injury[creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),cardiac troponin I(cTnI),aspartate aminotransferase(AST)]were observed and compared between the two groups,the relationship between the peripheral blood miRNA-21、PTEN mRNA and the markers of myocardial injury was observed by Pearson correlation analysis.The patients of the MP infection group were divided into the poor prognosis group and the favorable prognosis group according to the major adverse cardiovascular events(MACE)within 3 months.The expression levels of peripheral blood miRNA-21 and PTEN mRNA were compared between the two groups,and the efficiencies of the indexes in prediction of poor prognosis was analyzed.RESULTS The expression levels of peripheral blood miRNA-21 and PTEN mRNA as well as the levels of serum CK-MB,LDH,cTnI and AST were higher in the MP infection group than in the non-MP infection group(P<0.05).Pearson correlation analysis showed that the relative expression levels of peripheral blood miRNA-21 and PTEN mRNA were positively correlated with the levels of serum CK-MB,LDH,cTnI and AST(P<0.05).The relative expression levels of peripheral blood miRNA-21 and PTEN mRNA of the poor prognosis group were higher than those of the favorable prognosis group(P<0.05).Receiver operating characteristic(ROC)curve analysis indicated that the joint detection of peripheral blood miRNA-21 and PTEN mRNA had high value in prediction of poor pr

关 键 词：慢性心力衰竭 肺炎支原体感染 微小RNA-21 蛋白酪氨酸磷酸酶基因 心肌损伤 预后 

分 类 号：R541.6[医药卫生—心血管疾病]