2022 年第 9 期 第 17 卷

血浆外泌体微小RNA-206和N末端B型脑钠肽前体及同型半胱氨酸在心力衰竭患者中的表达水平及应用价值

Expression and diagnostic value of plasma exosome microRNA-206, serum N-terminal pro-brain natriuretic peptide and homocysteine in patients with heart failure

作者：赵娟1刘婷1魏红1王姣2刘志强2

英文作者：Zhao Juan1 Liu Ting1 Wei Hong1 Wang Jiao2 Liu Zhiqiang2

单位：1新疆医科大学第一附属医院综合心脏内科，乌鲁木齐830054；2新疆医科大学第一附属医院心血管内科，乌鲁木齐830054

英文单位：1Department of General Cardiology the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China; 2Department of Cardiovascular Medicine the First Affiliated Hospital of Xinjiang Medical University Urumqi 830054 China

关键词：心力衰竭；外泌体微小RNA-206；N末端B型脑钠肽前体；同型半胱氨

英文关键词：Heartfailure;ExosomemicroRNA-206;N-terminalpro-brainnatriureticpeptide;Homocysteine

• 摘要：

• 目的 探讨血浆外泌体微小RNA（miR）-206、N末端B型脑钠肽前体（NT-proBNP）、同型半胱氨酸（Hcy）在心力衰竭患者中的表达水平，同时分析各指标对心力衰竭的临床诊断价值。方法  选取2020年1月至2021年6月入住新疆医科大学第一附属医院的病历资料相对完整的心力衰竭患者105例纳入观察组，选取同期在新疆医科大学第一附属医院健康体检者113例作为对照组。比较2组人群血浆外泌体miR-206、NT-proBNP、Hcy水平及超声心动图指标，分析心力衰竭患者血浆外泌体miR-206、NT-proBNP、Hcy水平与超声心动图指标的相关性。采用受试者工作特征曲线分析血浆外泌体miR-206和NT-proBNP、Hcy对心力衰竭的诊断价值。结果  观察组血浆外泌体miR-206、NT-proBNP、Hcy水平及左心房内径(LAD)、左心室舒张末期内径(LVEDD)高于/大于对照组，左心室射血分数(LVEF)低于对照组，差异均有统计学意义（均P＜0.05）。Pearson相关性分析结果显示，心力衰竭患者血浆外泌体miR-206、NT-proBNP、Hcy水平与LAD、LVEDD均呈正相关，与LVEF均呈负相关（均P＜0.05）。受试者工作特征曲线分析结果显示，miR-206预测心力衰竭的截断值为0.687，敏感度为0.648，特异度为1.000；NT-proBNP预测心力衰竭的截断值为348.487 ng/L，敏感度为0.981，特异度为0.965；Hcy预测心力衰竭的截断值为8.720 μmol/L，敏感度为0.857，特异度为0.805。结论 心力衰竭患者血浆外泌体miR-206、NT-proBNP、Hcy水平均升高，三者对心力衰竭均有一定的诊断价值。

• Objective  To investigate the expression levels of plasma exosome microRNA (miR)-206, serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and homocysteine (Hcy) in patients with heart failure, and to analyze the clinical diagnostic value of each index in heart failure. Methods  Totally 105 patients with heart failure were enrolled into the observation group,  who were admitted to the First Affiliated Hospital of Xinjiang Medical University with relatively complete medical records from January 2020 to June 2021. Another 113 healthy physical examinees in the hospital were enrolled into the control group. The levels of plasma exosome miR-206, NT-proBNP, Hcy and echocardiography were compared between the two groups. The correlation between the levels of plasma exosome miR-206, NT-proBNP, Hcy and echocardiography in patients with heart failure was analyzed. The diagnostic value of plasma exosome miR-206, NT-proBNP and Hcy in heart failure was analyzed by the reveiver operating characteristic curve. Results  Levels of plasma exosome miR-206, NT-proBNP, Hcy, left atrial diameter (LAD) and left ventricular end diastolic diameter (LVEDD) in the observation group were higher/greater than those in the control group, and the level of left ventricular ejection fraction (LVEF) in the observation group was lower than that in the control group (all P＜0.05). Pearson correlation analysis showed that the levels of plasma exosome miR-206, NT-proBNP and Hcy in patients with heart failure were positively correlated with LAD and LVEDD, and negatively correlated with LVEF (all P＜0.05). Receiver operating characteristic curve analysis showed that the cut-off value of miR-206 for predicting heart failure was 0.687, the sensitivity was 0.648, and the specificity was 1.000; the cut-off value of NT-proBNP in predicting heart failure was 348.487 ng/L, the sensitivity was 0.981, and the specificity was 0.965; the cut-off value of Hcy for predicting heart failure was 8.720 μmol/L, the sensitivity was 0.857, and the specificity was 0.805. Conclusion  The levels of plasma exosome miR-206, serum NT-proBNP and Hcy increase in patients with heart failure, which have certain diagnostic value for heart failure.