Micro RNA-21在慢性阻塞性肺疾病并发肺动脉高压患者的表达及临床意义

摘要

Objective To investigate the expression and significance of serum microRNA-21 (miRNA-21) in the patients with chronic obstructive pulmonary disease (COPD) associated with pulmonary hypertension (PH ) .Methods Serum miRNA-21 and NT-proBNP were measured and pulmonary pressure was measured by Doppler echocardiography in 40 COPD patients (group A ) , 30 COPD patients with PH (group B) and 30 healthy people(group C) .Results Serum levels of miRNA-21 and NT-proBNP in group B were significantly higher than those in groups of A and C (P＜0 .01 ) .Serum level of miRNA-21 was positively correlated with pulmonary pressure and NT-proBNP(r=0 .37 and 0.44 ,P＜0 .05) .The area under ROC curve was 0.844 (95% CI= 0.762-0.926) .Taking 2.18 as a cutoff value ,the sensitivity and specificity for serum miRNA-21 to diagnose COPD associated with PH were 0.767 and 0.808 ,respectively .Conclusion Serum miRNA-21 in COPD patients with PH is increased significantly and may be considered as a potential biomarker for early detection and assessment of PH .%目的 探讨血清微小RNA-21(miRNA-21)表达在慢性阻塞性肺疾病(COPD)并发肺动脉高压(PH)患者的表达及临床意义.方法 COPD患者70例分为单纯COPD组(A组 ,40例)和COPD并发PH组(B组 ,30例);同期健康体检人群作为对照组(C组 ,30例).检测血清miRNA-21表达和N-端脑钠肽前体(NT-proBNP)含量 ,心脏彩超测定肺动脉收缩压.结果 B组血清miRNA-21相对表达量高于A组与C组(P＜0 .01).miRNA-21与肺动脉收缩压和NT-proBNP呈正相关(r分别为0.37和 0.44 ,P＜0 .05 ).ROC 曲线分析显示 ,ROC曲线下面积为0.844 (95% CI= 0.762-0.926);取临界值2.18时 ,其诊断COPD患者并发PH的灵敏度为76.7% ,特异度为80.8% .结论COPD并发PH患者血清中miRNA-21明显升高 ,可能作为COPD患者并发 PH的早期诊断及病情评估的潜在生物标记物.