摘要
目的 探讨冠心病(CHD)合并高血压患者血清长链非编码核糖核酸宫颈癌高表达1(LncRNA CCHE1)、转录因子21(TCF21)与心肌缺血的相关性.方法 选取2020年12月—2023年12月陕西省榆林市第一医院心血管内科收治的合并高血压的CHD患者110例为高血压组,未合并高血压的CHD患者110例为非高血压组,根据是否发生心肌缺血将高血压组分为心肌缺血亚组79例和无心肌缺血亚组31例.采用实时荧光定量PCR法测定血清LncRNA CCHE1、TCF21表达;Pearson相关性分析血清LncRNA CCHE1、TCF21表达与心肌缺血总负荷(TIB)的相关性;多因素Logistic回归分析CHD合并高血压患者发生心肌缺血的影响因素;受试者工作特征(ROC)曲线评价血清LncRNA CCHE1、TCF21表达对CHD合并高血压患者发生心肌缺血的诊断价值.结果 高血压组血清LncRNA CCHE1表达高于非高血压组,血清TCF21表达低于非高血压组(t/P=19.133/＜0.001、17.259/＜0.001);心肌缺血亚组BMI、收缩压、三支血管病变比例、血清Hey水平、TIB、血清LncRNA CCHE1表达高于无心肌缺血亚组,血清TCF21 表达低于无心肌缺血亚组(t/P=3.524/0.001、2.705/0.008、12.265/0.002、5.280/＜0.001、24.638/＜0.001、15.994/＜0.001、9.280/＜0.001);Pearson相关性分析显示,CHD合并高血压患者血清LncRNA CCHE1表达与TIB呈正相关(r=0.536,P＜0.001),血清TCF21表达与TIB呈负相关(r=-0.508,P＜0.001);多因素Logistic回归分析显示,三支血管病变、LncRNA CCHE1表达高是CHD合并高血压患者发生心肌缺血的独立危险因素[OR(95％CI)=3.465(1.534～7.833)、1.743(1.135～2.678)],TCF21 表达高是独立保护因素[OR(95％CI)=0.528(0.312～0.895)];血清LncRNA CCHE1、TCF21表达及二者联合诊断CHD合并高血压患者发生心肌缺血的曲线下面积(AUC)分别为0.778、0.760、0.896,二者联合的AUC大于血清LncRNA CCHE1、TCF21表达单独诊断的AUC(Z/P=2.636/0.002、3.088/＜0.001).结论 CHD合并高血压患者血清LncRNA CCHE1表达增高、TCF21表达降低与心肌缺血有关,二者联合在心肌缺风险诊断中具有较高价值.
Abstract
Objective To investigate the correlation between serum long non-coding RNA cervical cancer high ex-pression 1(LncRNA CCHE1),transcription factor 21(TCF21)and myocardial ischemia in patients with coronary heart disease(CHD)complicated with hypertension.Methods A total of 110 CHD patients with hypertension admitted to the Cardiovas-cular Department of the Yulin First Hospital from December 2020 to December 2023 were selected as the hypertensive group and 110 CHD patients without hypertension as the non-hypertensive group.According to the occurrence of myocardial is-chemia,the hypertension group was divided into 79 cases of myocardial ischemia subgroup and 31 cases of non-myocardial ischemia subgroup.The expression levels of serum LncRNA CCHE1 and TCF21 were determined by real-time fluorescence quantitative PCR;Pearson correlation analysis was used to analyze the correlation between serum LncRNA CCHE1,TCF21 expression levels and total myocardial ischemia burden(TIB);Multivariate logistic regression analysis was used to analyze the influencing factors of myocardial ischemia in CHD patients with hypertension;The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum LncRNA CCHE1 and TCF21 expression levels for myocar-dial ischemia in CHD patients with hypertension.Results The expression level of serum LncRNA CCHE1 in the hyperten-sion group was higher than that in the non-hypertension group,and the expression level of serum TCF21 was lower than that in the non-hypertension group(t/P=19.133/＜0.001,17259/＜0.001);BMI,systolic blood pressure,proportion of three-vessel disease,serum Hcy level,TIB,serum LncRNA CCHE1 expression level in the myocardial ischemia subgroup were higher than those in the non-myocardial ischemia subgroup,and serum TCF21 expression level was lower than that in the non-myocardial ischemia subgroup(t/P=3.524/0.001,2.705/0.008,12.265/0.002,5.280/＜0.001,24.638/＜0.001,15.994/＜0.001,9280/＜0.001);Pearson correlation analysis showed that the expression level of serum LncRNA CCHE1 in CHD patients with hypertension was positively correlated with TIB(r=0.536,P＜0.001),and the expression level of serum TCF21 was negative-ly correlated with TIB(r=-0.508,P＜0.001);Multivariate Logistic regression analysis showed that three-vessel disease and high expression level of LncRNA CCHE1 were independent risk,factors for myocardial ischemia in CHD patients with hyper-tension[OR(95％CI)=3.465(1.534-7.833),1.743(1.135-2.678)],and high expression level of TCF21 was an independent pro-tective factor[OR(95％CI)=0.528(0312-0.895)];The area under the curve(AUC)of serum LncRNA CCHE1,TCF21 expres-sion levels and their combination in the diagnosis of myocardial ischemia in CHD patients with hypertension were 0.778,0.760 and 0.896,respectively.The AUC of the combination of the two was greater than that of serum LncRNA CCHE1 and TCF21 expression levels alone in the diagnosis of myocardial ischemia in CHD patients with hypertension(Z=2.636,3.088,P=0.002,＜0.001).Conclusion The increased expression of serum LncRNA CCHE1 and the decreased expression of TCF21 in CHD pa-tients with hypertension are related to myocardial ischemia.The combination of the two has a high value in the diagnosis of myocardial deficiency risk.
维普
万方数据