2023 年第 12 期 第 18 卷

外周血微小RNA-210水平对慢性阻塞性肺疾病患者继发肺动脉高压的预测价值

Predictive value of peripheral blood microRNA-210 level for secondary pulmonary hypertension in patients with chronic obstructive pulmonary disease

作者：陈思睿1蔡茜2朱应群2李喆2刘金华2

英文作者：Chen Sirui1 Cai Qian2 Zhu Yingqun2 Li Zhe2 Liu Jinhua2

单位：1湖南省长沙市第三医院急诊医学科，长沙410015；2湖南省长沙市第三医院呼吸内科，长沙410015

英文单位：1Department of Emergency Medicine the Third Hospital of Changsha Hunan Province Changsha 410015 China; 2Department of Respiratory Medicine the Third Hospital of Changsha Hunan Province Changsha 410015 China

关键词：慢性阻塞性肺疾病；微小RNA-210；肺动脉高压；早期诊断

英文关键词：Chronicobstructivepulmonarydisease;MicroRNA-210;Pulmonaryhypertension;Earlydiagnosis

• 摘要：

• 目的  探讨外周血微小RNA（miR）-210水平对慢性阻塞性肺疾病（COPD）患者继发肺动脉高压（PAH）的预测价值。方法  选取2019年1月至2020年12月于湖南省长沙市第三医院进行治疗的COPD患者100例作为COPD组，其中43例患者继发PAH（PAH亚组）、57例患者肺动脉压正常（非PAH亚组）。另选取同期本院体检健康者42人作为对照组。比较3组间miR-210水平及COPD亚组间血气分析、肺功能等临床资料。应用Pearson相关性分析方法分析外周血miR-210水平与肺动脉收缩压的相关性；应用受试者工作特征（ROC）曲线分析miR-210对COPD继发PAH的预测价值。结果  COPD组血清miR-210水平低于对照组［（13±5）比（30±6）］，差异有统计学意义（t=15.890，P<0.001）。PAH亚组miR-210、动脉血氧分压、第1秒用力呼气容积、第1秒用力呼气容积与用力肺活量比值低于非PAH亚组，差异均有统计学意义（均P<0.05）。Pearson相关性分析结果显示PAH亚组患者外周血miR-210水平与肺动脉收缩压呈负相关（P<0.05）。ROC曲线分析结果显示，外周血miR-210水平预测COPD继发PAH的曲线下面积为0.881，特异度和敏感度分别为76.2%和86.2%，约登指数为0.61，预测的截断值为7.5。结论  外周血miR-210表达水平对COPD患者继发PAH有预测价值。

• Objective To explore the predictive value of peripheral blood microRNA(miR)-210 level for secondary pulmonary hypertension(PAH) in patients with chronic obstructive pulmonary disease(COPD). Methods From January 2019 to December 2020, 100 patients with COPD treated in the Third Hospital of Changsha, Hunan Province were selected as the COPD group, including 43 patients with secondary PAH(PAH subgroup) and 57 patients with normal pulmonary artery pressure(non PAH subgroup). In addition, 42 healthy people who underwent physical examination in our hospital during the same period were selected as the control group. The clinical data such as miR-210 level (among 3 groups), blood gas analysis and lung function (between COPD subgroups) were compared. Pearson correlation analysis was used to analyze the correlation between peripheral blood miR-210 level and pulmonary artery systolic pressure. The predictive value of miR-210 for secondary PAH in COPD was analyzed by receiver operating characteristic curve. Results  The serum miR-210 level in the COPD group was lower than that in the control group［(13±5) vs (30±6)］(t=15.890, P<0.001). The miR-210, arterial partial pressure of oxygen, forced expiratory volume at the first second, ratio of forced expiratory volume in the first second to forced vital capacity in the PAH subgroup were lower than those in the non PAH subgroup (all P<0.05). Pearson correlation analysis showed that the miR-210 level of peripheral blood was negatively correlated with pulmonary artery systolic pressure in PAH subgroup (P<0.05). The receiver operating characteristic curve analysis results showed that the area under the curve for predicting secondary PAH in COPD by the miR-210 level of peripheral blood was 0.881, with specificity and sensitivity of 76.2% and 86.2%, respectively. The Youden index was 0.61, and the cutoff value for prediction was 7.5. Conclusion The expression level of peripheral blood miR-210 has predictive value for secondary PAH in patients with COPD.