标题：老年慢性心力衰竭患者血清miR-223、NLRP3水平与心肌重构及心功能的相关性

      作者：刘艳 1，史伟东 2    1.宝鸡市人民医院老年病科，陕西 宝鸡 721000；2.宝鸡市人民医院心内科，陕西 宝鸡 721000

      卷次： 2022年33卷19期

      【摘要】 目的 探讨老年慢性心力衰竭(CHF)患者血清微小RNA-233 (miR-223)、Nod样受体蛋白3 (NLRP3)水平与心肌重构及心功能的相关性。方法 选择2019年1月至2020年12月在宝鸡市人民医院接受治疗的100例老年CHF患者作为观察组，按照纽约心脏病学会(NYHA)心功能分级将其分为心功能Ⅱ级组(n=35)、心功能Ⅲ级组(n=30)和心功能Ⅳ级组(n=35)，另选择同期 100例体检健康者作为对照组。比较所有受检者的一般资料、血清NLRP3和miR-223水平，以及心肌重构参数[左室后壁厚度(LVPWT)、左室质量指数(LVMI)、左室重构指数(LVRI)]和心功能指标[左室射血分数(LVEF)、心输出量(CO)]。采用Pearson相关性分析miR-223、NLRP3水平与心肌重构及心功能指标的相关性。结果 观察组患者的血清miR-223、NLRP3水平分别为1.37±0.38、(1.57±0.12) ng/mL，明显高于对照组的0.21±0.01、(0.34±0.06) ng/mL，差异均有统计学意义(P<0.05)；观察组患者的LVPWT、LVMI分别为(10.37±0.23) mm、(139.67±8.36) g/m2，明显高于对照组的(7.67±0.63) mm、(90.34±3.06) g/m2，LVRI为(0.88±0.04) g/mL，明显低于对照组的(1.27±0.84) g/mL，差异均有统计学意义(P<0.05)；观察组患者的CO、LVEF分别为(5.69±1.78)mL/min、(47.13±6.43)%，明显低于对照组的(7.83±2.34) mL/min、(54.07±4.94)%，差异均有统计学意义(P<0.05)；心功能Ⅳ级组患者的 miR-223、NLRP3、LVPWT、LVMI明显高于心功能Ⅲ级组和心功能Ⅱ级组，心功能Ⅲ级组患者的miR-223、NLRP3、LVPWT、LVMI明显高于心功能Ⅱ级组，而心功能Ⅳ级组患者的LVRI、CO、LVEF明显低于心功能Ⅲ级组和心功能Ⅱ级组，心功能Ⅲ级组患者的LVRI、CO、LVEF明显低于心功能Ⅱ级组，差异均有统计学意义(P<0.05)；经 Pearson相关性分析结果显示，老年CHF患者miR-223水平与LVPWT、LVMI均呈明显正相关(r=0.789、0.874，P<0.05)，与 LVRI、CO、LVEF均呈明显负相关(r=-0.746、-0.809、-0.667，P<0.05)；NLRP3水平与 LVPWT、LVMI均呈明显正相关(r=0.729、0.887，P<0.05)，与 LVRI、CO、LVEF均呈明显负相关(r=-0.701、-0.843、-0.688，P<0.05)，miR-223与NLRP3呈正相关(r=0.674，P<0.05)。结论 老年CHF患者血清miR-223、NLRP3水平明显升高，且与患者心肌重构和心功能密切相关。
      【关键词】 老年慢性心力衰竭；微小RNA-233；Nod样受体蛋白3；心肌重构；心功能；相关性
      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2022）19—2471—05

Correlation of serum microRNA-233 and NOD-like receptor protein 3 levels with myocardial remodeling andcardiac function in elderly patients with chronic heart failure.
LIU Yan 1, SHI Wei-dong 2. 1. Department of GeriatricDisease, Baoji People's Hospital, Baoji 721000, Shaanxi, CHINA; 2. Department of Cardiology, Baoji People's Hospital,Baoji 721000, Shaanxi, CHINA
【Abstract】 Objective To investigate the correlation of serum microRNA-233 (miR-223) and NOD-like recep-tor protein 3 (NLRP3) levels with myocardial remodeling and cardiac function in elderly patients with chronic heart fail-ure (CHF). Methods One-hundred elderly CHF patients treated in Baoji People's Hospital from January 2019 to De-cember 2020 were selected as the observation group. According to the cardiac function classification of New York HeartAssociation (NYHA), they were divided into grade Ⅱ cardiac function group (n=35), grade Ⅲ cardiac function group(n=30), and grade Ⅳ cardiac function group (n=35). In addition, 100 healthy people undergoing physical examinationduring the same period were selected as the control group. The general data, serum NLRP3, and miR-223 levels, myocar-dial remodeling parameters [left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI), leftventricular remodeling index (LVRI)], and cardiac function indexes [left ventricular ejection fraction (LVEF), cardiacoutput (CO)] of all subjects were compared. Pearson correlation was used to analyze the correlation between the levelsof miR-223, NLRP3 and myocardial remodeling, cardiac function indexes. Results The levels of serum miR-223 andNLRP3 in the observation group were 1.37±0.38 and (1.57±0.12) ng/mL, which were significantly higher than 0.21±0.01 and (0.34 ± 0.06) ng/mL in the control group (P<0.05). The LVPWT and LVMI in the observation group were(10.37±0.23) mm and (139.67±8.36) g/m2, which were significantly higher than (7.67±0.63) mm and (90.34±3.06) g/m2