长链非编码RNA MYCNOS预测脓毒症合并急性心力衰竭患者发生主要不良心血管事件的价值研究

doi:10.3760/cma.j.issn.1007-1245.2022.18.003

国际医药卫生导报 ›› 2022, Vol. 28 ›› Issue (18): 2528-2533.DOI: 10.3760/cma.j.issn.1007-1245.2022.18.003

长链非编码RNA MYCNOS预测脓毒症合并急性心力衰竭患者发生主要不良心血管事件的价值研究

刘效锋^1,2 邵碧波^1,2

¹鄂东医疗集团黄石市中心医院（湖北理工学院附属医院）急诊医学科，黄石　435000； ²肾脏疾病发生与干预湖北省重点实验室，黄石　435000

收稿日期:2022-04-15 出版日期:2022-09-15 发布日期:2022-10-11
通讯作者: 邵碧波，Email：75266477@qq.com
基金资助:
湖北省卫生健康委员会联合基金面上项目（WJ2019H461）

Predictive value of lncRNA MYCNOS for major adverse cardiovascular events in patients with sepsis and acute heart failure

Liu Xiaofeng^1,2, Shao Bibo^1,2

¹Department of Emergency Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi 435000, China; ²Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, Huangshi 435000, China

Received:2022-04-15 Online:2022-09-15 Published:2022-10-11
Contact: Shao Bibo, Email: 75266477@qq.com
Supported by:
General Project of Hubei Provincial Health Commission Joint Fund (WJ2019H461)

摘要/Abstract

摘要： 目的　探究长链非编码RNA MYCNOS（lncRNA MYCNOS）对脓毒症合并急性心力衰竭患者发生主要不良心血管事件（major adverse cardiovascular events，MACE）的预测价值。方法　选取鄂东医疗集团黄石市中心医院2019年3月至2022年1月177例确诊为脓毒症合并急性心力衰竭的患者，其中男125例，女52例，年龄（61.77±6.14）岁。所有患者随访截止时间为2022年2月1日，根据随访是否发生MACE将患者分为MACE组和非MACE组。比较两组患者外周血中的lncRNA MYCNOS相对表达水平及其他一般临床资料，通过Cox回归分析脓毒症合并急性心力衰竭患者发生MACE的危险因素，Pearson相关性分析lncRNA MYCNOS与各危险因素的相关性。绘制受试者工作特征曲线（receiver operating characteristic curve，ROC），用ROC评估lncRNA MYCNOS对脓毒症合并急性心力衰竭患者发生MACE的预测价值。计量资料采用独立样本t检验或秩和检验，计数资料采用χ²检验。结果　32例患者随访期间发生MACE。MACE患者慢性心功能不全占比、左心室射血分数（LVEF）低于非MACE患者（均P<0.05），外周血C反应蛋白（CRP）值、N末端B型脑钠肽前体（NTproBNP）、中性粒细胞/淋巴细胞比值（NLR）、机械通气时间、住ICU时间、住院时间和外周血中lncRNA MYCNOS相对水平高于非MACE患者（均P<0.05）。多因素Cox回归分析显示，NLR（HR=1.360，95%CI：1.026～1.791，P=0.032）和lncRNA MYCNOS（HR=5.32，95%CI：1.421～19.930，P=0.013）为脓毒症合并急性心力衰竭患者发生MACE的影响因素。相关性分析结果显示，lncRNA MYCNOS与NLR呈正相关性（r=0.412，P<0.001）。ROC表明，lncRNA MYCNOS诊断脓毒症合并急性心力衰竭患者发生MACE的切点为1.829，曲线下面积（AUC）为0.976（95%CI：0.951～1.000）。结论　lncRNA MYCNOS为脓毒症合并急性心力衰竭患者发生MACE的独立预测因子。

关键词: 长链非编码RNA MYCNOS, 脓毒症, 急性心力衰竭, 主要不良心血管事件

Abstract: Objective　To investigate the predictive value of long non-coding RNA MYCNOS (lncRNA MYCNOS) for major adverse cardiovascular events (MACE) in patients with sepsis and acute heart failure. Methods　One hundred and seventy-seven patients diagnosed with sepsis combined with acute heart failure in Huangshi Central Hospital, Edong Healthcare Group from March 2019 to January 2022 were selected, including 125 males and 52 females, aged (61.77±6.14) years, and all patients were followed up until February 1, 2022. The patients were divided into a MACE group and a non-MACE group according to whether MACE occurred during the follow-up. The relative expression level of lncRNA MYCNOS in the peripheral blood and other general clinical information were compared between the two groups, the risk factors for the occurrence of MACE in the patients with sepsis and acute heart failure were analyzed by Cox regression analysis, the correlations between lncRNA MYCNOS and risk factors were analyzed by Pearson correlation analysis, and the predictive value of lncRNA MYCNOS for MACE in the patients with sepsis and acute heart failure was evaluated by the receiver operating characteristic curve (ROC). Independent sample t test or rank sum test was used for the measurement data, and chi-square test was used for the count data. Results　MACE occurred during the follow-up in 32 patients. The proportion of chronic cardiac insufficiency and left ventricular ejection fraction (LVEF) of the MACE patients were lower than those of the non-MACE patients (both P<0.05), and the peripheral blood C-reactive protein (CRP) value, N-terminal pro-B-type brain natriuretic peptide (NTproBNP), ratio of neutrophil/lymphocyte (NLR), mechanical ventilation time, length of ICU stay, length of hospital stay, and relative level of lncRNA MYCNOS in the peripheral blood were higher than those of the non-MACE patients (all P<0.05). Multivariate Cox regression analysis showed that NLR (HR=1.360, 95%CI: 1.026-1.791, P=0.032) and lncRNA MYCNOS (HR=5.32, 95%CI: 1.421-19.930, P=0.013) were the influencing factors of MACE in patients with sepsis and acute heart failure. Correlation analysis showed that lncRNA MYCNOS was positively correlated with NLR (r=0.412, P<0.001). The ROC showed that the cut-off point of lncRNA MYCNOS in the diagnosis of MACE in patients with sepsis and acute heart failure was 1.829, and the area under the curve (AUC) was 0.976 (95%CI: 0.951-1.000). Conclusion　LncRNA MYCNOS is an independent predictor of the development of MACE in sepsis combined with acute heart failure.

Key words: , Long non-coding RNA MYCNOS, Sepsis, Acute heart failure, Major adverse cardiovascular events

刘效锋邵碧波. 长链非编码RNA MYCNOS预测脓毒症合并急性心力衰竭患者发生主要不良心血管事件的价值研究[J]. 国际医药卫生导报, 2022, 28(18): 2528-2533.

Liu Xiaofeng, Shao Bibo. Predictive value of lncRNA MYCNOS for major adverse cardiovascular events in patients with sepsis and acute heart failure[J]. International Medicine and Health Guidance News, 2022, 28(18): 2528-2533.

参考文献

[1] Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations[J]. Am J Respir Crit Care Med, 2016, 193(3):259-272. DOI: 10.1164/rccm.201504-0781OC.
[2] Yeh RW, Sidney S, Chandra M, et al. Population trends in the incidence and outcomes of acute myocardial infarction[J]. N Engl J Med, 2010, 362(23):2155-2165. DOI: 10.1056/NEJMoa0908610.
[3] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019[J]. CA Cancer J Clin, 2019, 69(1):7-34. DOI: 10.3322/caac.21551.
[4] Liu V, Escobar GJ, Greene JD, et al. Hospital deaths in patients with sepsis from 2 independent cohorts[J]. JAMA, 2014, 312(1):90-92. DOI: 10.1001/jama.2014.5804.
[5] 马亮,关晓楠,刘文婷,等.伊伐布雷定在脓毒症合并急性心力衰竭易损期患者中应用1年随访疗效分析[J].中国急救医学,2021,41(9):759-763. DOI:10.3969/j.issn.1002- 1949.2021.09.005.
[6] 刘兴超.急性失代偿期心力衰竭患者不良心血管事件发生的影响因素[J].河南医学研究,2021,30(34):6450-6453. DOI:10.3969/j.issn.1004-437X.2021.34.038.
[7] 揭海,吴源聪,邢建庞.长链非编码RNA RMRP对急性心肌梗死并发急性心力衰竭的预测价值[J].国际检验医学杂志,2021,42(19):2384-2389. DOI:10.3969/j.issn.1673-4130. 2021.19.019.
[8] 王圆圆,张琪.长链非编码RNA在脓毒症多器官功能障碍中的研究进展[J/CD].中华危重症医学杂志(电子版),2021,14(2):161-164. DOI:10.3877/cma.j.issn.1674-6880. 2021.02.014.
[9] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].感染、炎症、修复,2019,20(1):3-22. DOI:10.3969/j.issn.1672-8521.2019.01.001.
[10] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789. DOI:10.3760/cma.j.issn.0253- 3758.2018.10.004.
[11] 何应丰,陈建军,周亮亮,等.血浆长链非编码RNA MALAT1对脓毒症的诊断、严重程度以及预后的评估价值研究[J].南京医科大学学报(自然科学版),2021,41(12):1811-1815. DOI:10.7655/NYDXBNS20211217.
[12] Yan L, Zhang Y, Zhang W, et al. lncRNA-NRF is a potential biomarker of heart failure after acute myocardial infarction[J]. J Cardiovasc Transl Res, 2020, 13(6):1008-1015. DOI: 10.1007/s12265-020-10029-0.
[13] 童行,李庭浩,曹洪豪,等.8-自噬相关lncRNA模型在预测膀胱癌患者预后中的作用[J].第三军医大学学报,2021,43(23):2532-2541. DOI:10.16016/j.1000-5404. 202106120.
[14] 宋蕾,张建国,刘英勋.LncRNA SNHG3通过调控miR-410-3p对脓毒症血管内皮细胞增殖、凋亡的影响[J].广西医科大学学报,2021,38(10):1921-1926. DOI:10.16190/j.cnki.45-1211/r.2021.10.016.
[15] 林润,罗凌青,饶平,等.lncRNA A＿30＿P01029806减轻脓毒症急性肺损伤的机制研究[J].现代医学,2021,49(8):897-903.
[16] Song L, Duan X, Zeng X, et al. Regulatory mechanism of LINC00152 on aggravating heart failure through triggering fibrosis in an infarcted myocardium[J]. Dis Markers, 2021, 2021:2607358. DOI: 10.1155/2021/2607358.
[17] Zhao P, Li T, Wang Y, et al. LncRNA MYCNOS promotes glioblastoma cell proliferation by regulating miR-216b/FOXM1 axis[J]. Metab Brain Dis, 2021, 36(6):1185-1189. DOI: 10.1007/s11011-021-00729-0.
[18] Yu J, Ou Z, Lei Y, et al. LncRNA MYCNOS facilitates proliferation and invasion in hepatocellular carcinoma by regulating miR-340[J]. Hum Cell, 2020, 33(1):148-158. DOI: 10.1007/s13577-019-00303-y.
[19] Pellegrina DVDS, Severino P, Barbeiro HV, et al. Insights into the function of long noncoding RNAs in sepsis revealed by gene co-expression network analysis[J]. Noncoding RNA, 2017, 3(1):5. DOI: 10.3390/ncrna3010005.
[20] Zhang G, Zheng D, Chen X, et al. miR-152-mediated MKK7 downregulation is attenuated by MYCNOS in ovarian adenocarcinoma[J]. Oncol Lett, 2021, 22(6):841. DOI: 10.3892/ol.2021.13102.
[21] 李慧琳,刘舒嫣,刘盛,等.检测脓毒症患者白细胞分类及中性粒细胞/淋巴细胞比值的临床意义[J].热带医学杂志,2022,22(1):32-36,封4. DOI:10.3969/j.issn.1672-3619. 2022.01.007.
[22] 王玲玲,陈蕊,董家辉,等.中性粒细胞/淋巴细胞比值对老年脓毒症患者进展为慢重症的预测价值[J].中华危重病急救医学,2021,33(11):1291-1295. DOI:10.3760/cma.j.cn121430-20210628-00952.
[23] 李敬,张羽,李娜,等.新型炎性指标对急性心肌梗死早期心力衰竭的预测价值[J].中华老年心脑血管病杂志,2022,24(3):243-246. DOI:10.3969/j.issn.1009-0126.2022. 03.006.

长链非编码RNA MYCNOS预测脓毒症合并急性心力衰竭患者发生主要不良心血管事件的价值研究

Predictive value of lncRNA MYCNOS for major adverse cardiovascular events in patients with sepsis and acute heart failure

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