蒋健刚 杜晓马 兰景良 晏程远 沈昕

[摘要] 目的 探討外周血miRNA-155在冠心病心力衰竭患者中的表达及与人附睾分泌蛋白4（HE4）、血红素加氧酶-1（HO-1）的相关性研究。 方法 选取2018年5月至2020年8月收治的冠心病心力衰竭患者64例为病例组，并随机选取接受健康体检的健康者64名作为对照组，对其进行彩色多普勒超声检查，以及血清HE4、HO-1及miRNA-155等指标的检测，分析外周血miRNA-155在冠心病心力衰竭患者中的表达及与HE4、HO-1的相关性。结果 病例组HE4、HO-1及miRNA-155的水平均高于对照组（P<0.05），病例组LVEF低于对照组（P<0.05）;病例组中心功能分级Ⅳ级患者的HE4、HO-1及miRNA-155水平均明显高于心功能分级Ⅲ级、Ⅱ级患者，LVEF低于心功能分级Ⅲ级、Ⅱ级患者（P<0.05），病例组中心功能分级Ⅲ级患者的HE4、HO-1及miRNA-155水平均高于心功能分级Ⅱ级患者（P<0.05），LVEF低于心功能分级Ⅱ级患者（P<0.05）;LVEF与血清HE4、HO-1及miRNA-155水平呈负相关（P<0.05）;血清HE4和HO-1水平与外周血miRNA-155水平呈正相关（P<0.05）。 结论 冠心病心力衰竭患者存在HE4、HO-1及miRNA-155水平明显升高情况，且其上升幅度随心功能分级升高而升高，HE4、HO-1及miRNA-155升高幅度与冠心病心力衰竭患者心功能损伤严重程度存在相关性。

[关键词] 人附睾分泌蛋白4;血红素加氧酶-1;miRNA-155;冠心病;心力衰竭

[中图分类号] R541.4          [文献标识码] A          [文章编号] 1673-9701（2021）36-0021-04

Research on the expression of miRNA-155 in peripheral blood in patients with coronary heart disease and cardiac failure and its correlation with HE4 and HO-1

JIANG Jian′gang   DU Xiaoma   LAN Jingliang   YAN Chengyuan   SHEN Xin

Department of Cardiology， Zhejiang Chinese Medical University Affiliated Jinhua Hospital of Traditional Chinese Medicine， Jinhua   321000， China

[Abstract] Objective To investigate the expression of miRNA-155 in peripheral blood in patients with coronary heart disease and cardiac failure and its correlation with human epididymal secretory protein 4 （HE4） and heme oxygenase-1 （HO-1）. Methods Patients with coronary heart disease and cardiac failure admitted from May 2018 to August 2020 were selected as the case group （n=64）， and healthy people undergoing physical examination were randomly selected as the control group （n=64）. The patients were examined by color Doppler ultrasound; and serum HE4， HO-1 and miRNA-155 were detected. The expression of miRNA-155 in peripheral blood and its correlation with HE4， HO-1 in patients with coronary heart disease and cardiac failure were analyzed. Results The levels of HE4， HO-1 and miRNA-155 in the case group were all higher than those in the control group （P<0.05）， while LVEF in the case group was lower than that in the control group（P<0.05）. The levels of HE4， HO-1 and miRNA-155 in patients with central functional classification Ⅳ were all significantly higher than those with cardiac functional classification III and II， and LVEF was lower than those with cardiac functional classification Ⅲ and Ⅱ（all P<0.05）. The levels of HE4， HO-1 and miRNA-155 in patients with grade Ⅲ were all higher than those in patients with grade Ⅱ （P<0.05）， LVEF was negatively correlated with serum HE4， HO-1 and miRNA-155 levels （all P<0.05）. LVEF was lower than that of patients with cardiac function grade Ⅱ（P<0.05）. LVEF was negatively correlated with serum HE4， HO-1 and miRNA-155 levels （P<0.05）. The levels of serum HE4 and HO-1 were positively correlated with the level of miRNA-155 in peripheral blood （P<0.05）. Conclusion The levels of HE4， HO-1 and miRNA-155 are obviously increased in patients with coronary heart disease and cardiac failure， and their rising range boosts with the increase of functional classification. The rising range of HE4， HO-1 and miRNA-155 is correlated with the severity of cardiac function injury in patients with coronary heart disease and cardiac failure.

[Key words] Human epididymis secretory protein 4; Heme oxygenase-1; MiRNA-155; Coronary heart disease; Cardiac failure

心力衰竭是各种器质性心脏病发展为终末期的临床症状，有较高的致残率和致死率，对患者身体健康构成严重的威胁，冠心病是导致心力衰竭的主要因素之一[1]。血清微小RNA155（miRNA-155）可以促进心肌细胞的纤维化，损伤心肌细胞的收缩功能，从而导致慢性心力衰竭的发生[2]。人附睾分泌蛋白4（HE4）与恶性肿瘤存在密切联系，其主要存在于神经组织及胚胎上皮细胞中[3]。……