老年慢性心力衰竭病人血清微RNA-21、白细胞介素-6、脑利钠肽水平与预后的关系研究  

Relationship between serum miRNA-21,IL-6,BNP levels and prognosis in elderly patients with chronic heart failure

作　　者：侯杰 王丽芳 李园春[2] 刘勇 姚海涛 HOU Jie;WANG Lifang;LI Yuanchun;LIU Yong;YAO Haitao(Emergency Department,Tangshan Central Hospital,Tangshan,Hebei 063008,China;Internal Medicine Department,Tangshan Fengnan District Hospital,Tangshan,Hebei 063300,China;Third Internal Medicine Department,Hebei Yanshan County People's Hospital,Cangzhou,Hebei 061300,China)

机构地区：[1]唐山中心医院急诊科,河北唐山063008 [2]唐山市丰南区医院内科,河北唐山063300 [3]盐山县人民医院内三科,河北沧州061300

出　　处：《安徽医药》2024年第4期690-694,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省医学科学研究课题计划项目(20211296)。

摘　　要：目的 研究老年慢性心力衰竭(CHF)病人血清微RNA-21(miRNA-21)、白细胞介素-6(IL-6)、脑利钠肽(BNP)与预后的关系。方法 将唐山中心医院2020年1月至2021年1月住院的老年慢性心力衰竭病人120例作为研究对象,随访至2022年1月31日,以发生CHF再入院、全因死亡的病人为预后不良(n=46),其余病人为预后良好组(n=74),比较两组血清miRNA-21、IL-6、BNP水平及心功能。采用logistic回归分析老年CHF病人预后的影响因素。建立受试者操作特征(ROC)曲线,分析血清miRNA-21、IL-6、BNP水平对老年CHF病人预后的评估价值。结果 预后良好组心功能Ⅱ级、Ⅲ级、Ⅳ级的构成比例分别为50.00%、31.08%、18.92%,预后不良组分别为10.87%、47.83%、41.30%(P<0.05)。预后良好组LVEF高于预后不良组,LVEDD低于预后不良组(P<0.05)。预后良好组血清miRNA-21、IL-6、BNP水平均低于预后不良好组(P<0.05)。logistic回归显示:左室射血分数(LVEF)及三个血清指标(miRNA-21、IL-6、BNP)均是CHF病人预后不良的危险因素(P<0.05,OR>1)。ROC分析显示:miRNA-21、IL-6、BNP单独与联合预测CHF病人预后的AUC 95%CI分别为:0.74(0.52,0.96)、0.69(0.43,0.93)、0.76(0.58,0.94)、0.86(0.77,0.94),联合预测效能最高。结论 血清miRNA-21、IL-6、BNP水平升高是CHF病人预后不良的危险因素,通过血清miRNA-21、IL-6、BNP水平可预测CHF病人的预后。在预测价值上miRNA-21最高,BNP次之,第三为IL-6。三种指标联合预测价值高于任何单一指标。Objective To investigate the relationship between serum miRNA-21,interleukin-6(IL-6),brain natriuretic factor(BNP)and prognosis in elderly patients with chronic heart failure(CHF).Methods One hundred and twenty elderly patients with chronic heart failure hospitalized in Tangshan Central Hospital from January 2020 to January 2021 were selected as research objects.The pa-tients who had CHF readmission and died of all causes were treated as poor prognosis group(n=46),and the other patients were treated as good prognosis group(n=74).Serum miRNA-21,IL-6,BNP levels and cardiac function were compared between the two groups.Lo-gistic regression was used to analyze the influencing factors of the prognosis of elderly CHF patients.The ROC curve was established to analyze the prognostic value of serum miRNA-21,IL-6,BNP levels in elderly patients with CHF.Results The ratios of cardiac func-tion gradeⅡ,ⅢandⅣin the good prognosis group were 50.00%,31.08%and 18.92%,respectively,and those in the poor prognosis group was 10.87%,47.83%and 41.30%,respectively,and the differences were statistically significant(P<0.05).The left ventricular ejection fraction(LVEF)of the good prognosis group was higher than that of the poor prognosis group,and the left ventricular end-dia-stolic dimension(LVEDD)was lower than that of the poor prognosis group,and the differences were statistically significant(P<0.05).The levels of serum miRNA-21,IL-6 and BNP in the good prognosis group were lower than those in the poor prognosis group,and the differences were statistically significant(P<0.05).Logistic regression showed that LVEF and three serum indexes(miRNA-21,IL-6,BNP)were risk factors for poor prognosis in CHF patients(P<0.05,OR>1).ROC analysis showed that the AUC 95%CI of miRNA-21,IL-6 and BNP in predicting CHF prognosis alone and in combination were as follows:0.74(0.52,0.96),0.69(0.43,0.93),0.76(0.58,0.94),0.86(0.77,0.94),indicating the combined prediction efficiency was the highest.Conclusion Elevated serum miRNA-21,IL-6 and BNP levels are r

关 键 词：心力衰竭 微RNA-21 白细胞介素-6 脑利钠肽 预后 老年人 

分 类 号：R541.6[医药卫生—心血管疾病]