Kan Changli, Cao Junjie, Hou Jing, Jing Xiangyang, Zhu Yanju, Zhang Jinhuan, Guo Yanwei, Chen Xuerong
Department of Obstetrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China.
Department of Geriatrics, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, P.R. China.
Exp Ther Med. 2019 Apr;17(4):3129-3135. doi: 10.3892/etm.2019.7286. Epub 2019 Feb 19.
Correlation of miR-21 and B-type natriuretic peptide (BNP) with pregnancy-induced hypertension (PIH) complicated with heart failure and the diagnostic value was investigated. Sixty patients with PIH complicated with heart failure admitted to Affiliated Hospital of Chengde Medical University from July 2016 to July 2017 were enrolled as the experimental group, and 35 normal pregnant women as the control group. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) method was used to determine the expression level of plasma miR-21 expression level. An automatic biochemical analyzer was used to determine plasma BNP expression level. Spearmans correlation analysis was used for the correlation analysis of miR-21 and BNP. ROC curve was used for evaluating the diagnostic values of miR-21 and BNP for PIH complicated with heart failure. miR-21 and BNP expression levels were higher in patients with PIH complicated with heart failure than those in the normal individuals, and were increased in line with the heart failure grade (P<0.001). The plasma miR-21 expression was positively correlated with BNP in patients with PIH complicated with heart failure (r=0.685, P<0.001). Both miR-21 and BNP had higher diagnostic values for PIH complicated with heart failure, in the diagnosis, the best cut-off value [odds ratio (OR)] of miR-21 was 1.113, with an area under curve (AUC) of 0.889 and a 95% confidence interval (CI) of 82.05-95.76%; the OR of BNP was 123, with an AUC of 0.747 and a 95% CI of 64.95-84.38%. Blood pressure, six-minute walk test (6MWT), left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were independent risk factors for the occurrence of PIH complicated with heart failure (P<0.05). In conclusion, miR-21 and BNP, highly expressed in patients with PIH complicated with heart failure, are expected to become important biomarkers for diagnosing PIH complicated with heart failure and judging the degree of heart failure in the patients, and worthy of clinical popularization and application.
研究了miR-21和B型利钠肽（BNP）与妊娠高血压综合征（PIH）合并心力衰竭的相关性及诊断价值。选取2016年7月至2017年7月在承德医学院附属医院收治的60例PIH合并心力衰竭患者作为实验组，35例正常孕妇作为对照组。采用逆转录-定量聚合酶链反应（RT-qPCR）法检测血浆miR-21表达水平。使用自动生化分析仪检测血浆BNP表达水平。采用Spearmans相关性分析对miR-21与BNP进行相关性分析。采用ROC曲线评估miR-21和BNP对PIH合并心力衰竭的诊断价值。PIH合并心力衰竭患者的miR-21和BNP表达水平高于正常个体，且随心力衰竭分级升高而升高（P<0.001）。PIH合并心力衰竭患者血浆miR-21表达与BNP呈正相关（r=0.685，P<0.001）。miR-21和BNP对PIH合并心力衰竭均具有较高的诊断价值，诊断时miR-21的最佳截断值[比值比（OR）]为1.113，曲线下面积（AUC）为0.889，95%置信区间（CI）为82.05-95.76%；BNP的OR为123，AUC为0.747，95%CI为64.95-84.38%。血压、六分钟步行试验（6MWT）、左心室射血分数（LVEF）和左心室舒张末期内径（LVEDD）是PIH合并心力衰竭发生的独立危险因素（P<0.05）。综上所述，miR-21和BNP在PIH合并心力衰竭患者中高表达，有望成为诊断PIH合并心力衰竭及判断患者心力衰竭程度的重要生物标志物，值得临床推广应用。
