外周血miR-223和血清BNP水平在慢性心力衰竭患者中的诊断价值

目的:探究慢性心力衰竭(chronic heart failure,CHF)患者外周血microRNA-223(miR-223)和血清B型利钠肽(B-type natriuretic peptide,BNP)水平及其诊断价值。方法:选取CHF患者65例(CHF组),其中美国纽约心脏病协会(New York Heart Association,NYHA)心功能分级Ⅱ级24例,Ⅲ级22例,Ⅳ级19例。另取40例同期在体检中心进行健康体检者(Control组),采用实时荧光定量PCR检测外周血中miR-223水平,ELISA检测血清BNP含量,ROC曲线评价miR-223及BNP对CHF的诊断价值。结果:CHF组左心室短轴缩短率及左心室射血分数显著低于Control组(P0.01);左心室舒张末期内径显著高于Control组(P0.01)。CHF组不同NYHA心功能分级患者miR-223和BNP水平均高于Control组,且miR-223和BNP水平随NYHA心功能分级逐渐递增,组间两两比较均显示统计学差异(P0.05)。miR-223诊断CHF的曲线下面积(area under the curve,AUC)为0.7375,临界值为43.51时灵敏度为92.82%,特异度为89.44%;BNP诊断CHF的AUC为0.7925,临界值为128 ng/L时灵敏度为92.93%,特异度为92.58%。结论:CHF患者外周血miR-223和血清BNP水平高于健康对照人群,其对CHF的诊断具有一定的临床参考价值。

Diagnostic Value of Peripheral Blood miR-223 and Serum BNP Levels for the Patients with Chronic Heart Failure

ABSTRACT Objective: To investigate the level of microRNA-223 (miR-223) in peripheral blood and serum B-type natriuretic peptide (BNP) level of patients with chronic heart failure (CHF), and to analyze their diagnostic value. Methods: Sixty-five patients with CHF were enrolled in the CHF group: 24 patients with New York Heart Association (NYHA) functional class II, 22 with class III and 19 with class IV. Another 40 healthy subjects who underwent a physical examination were included in the control group. The level of miR-223 in peripheral blood was measured by real-time quantitative PCR. The serum BNP was determined by ELISA. The ROC was used to evaluate the diagnostic value of miR-223 and BNP for CHF. Results: Compared to the control group, the left ventricular ejection fraction and fractional shortening were significantly lower, left ventricular end-diastolic diameter was significantly wider in the CHF group (all P<0.01). The level of miR-223 or BNP in the patients with CHF was higher than that in the control group (P<0.05), and the level of miR-223 or BNP gradually increased with NYHA functional class. The area under the curve (AUC) of miR-223 to diagnose CHF was 0.7375; while the cutoff of miR-223 was 43.51, sensitivity and specificity were 92.82% and 89.44%. The AUC of BNP was 0.7925; while the cutoff of BNP was 128 ng/L sensitivity and specificity were 92.93% and 92.58%. Conclusion: The level of miR-223 in peripheral blood and serum BNP level of patients with CHF are up-regulated, which had a good diagnostic value for CHF.