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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。
Objective To investigate the expression and clinical significance of serum microRNA-21 (miRNA-21) expression in patients with chronic obstructive pulmonary disease (COPD) complicated pulmonary hypertension (PH). Methods Seventy patients with COPD were divided into three groups: COPD group (40 cases) and COPD group (30 cases). In the same period, 30 healthy people were selected as control group (C group, 30 cases). Serum miRNA-21 expression and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured and pulmonary artery systolic pressure was measured by echocardiography. Results The relative expression of miRNA-21 in group B was higher than that in group A and C (P <0.01). There was a positive correlation between miRNA-21 and pulmonary artery systolic pressure and NT-proBNP (r = 0.37 and 0.44, P <0.05). ROC curve analysis showed that the area under the ROC curve was 0.844 (95% CI = 0.762-0.926). When the cutoff value was 2.18, the sensitivity and specificity of diagnosing COPD patients were 76.7% and 80.8% respectively. Conclusions The serum levels of miRNA-21 in patients with COPD complicated with PH are significantly increased, which may be used as potential biomarkers for the early diagnosis and assessment of PH complicated with COPD.