[1]朱媛媛,张赞伟.心功能分级、外周血微小RNA208a、 NOD样受体家族含吡啉结构域蛋白3水平及心率变异性与射血分数减低型心力衰竭患者不良预后结局的关系[J].陕西医学杂志,2026,(4):500-505,511.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.012]
　ZHU Yuanyuan,ZHANG Zanwei.The relationship between cardiac function classification,peripheral blood miRNA208a,NLRP3 level characteristics,heart rate variability and poor prognostic outcomes in patients with HFrEF[J].,2026,(4):500-505,511.[doi:DOI:10.3969/j.issn.1000-7377.2026.04.012]
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心功能分级、外周血微小RNA208a、 NOD样受体家族含吡啉结构域蛋白3水平及心率变异性与射血分数减低型心力衰竭患者不良预后结局的关系

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
500-505,511
栏目:
临床研究
出版日期:
2026-04-05

文章信息/Info

Title:
The relationship between cardiac function classification,peripheral blood miRNA208a,NLRP3 level characteristics,heart rate variability and poor prognostic outcomes in patients with HFrEF
作者:
朱媛媛; 张赞伟
（西安市第九医院心血管病院三病区，陕西 西安 710054）
Author(s):
ZHU Yuanyuan; ZHANG Zanwei
（Department of Cardiology,No.3 Ward,Xi’an No.9 Hospital,Xi’an 710054,China）
关键词:
射血分数减低; 心力衰竭; 心功能分级; 微小RNA208a; NOD样受体家族含吡啉结构域蛋白3; 心率变异性; 不良心血管事件
Keywords:
Reduced ejection fraction; Heart failure; Cardiac function classification; miRNA208a; NLRP3; Heart rate variability; Adverse cardiovascular events
分类号:
R 541.6
DOI:
DOI:10.3969/j.issn.1000-7377.2026.04.012
文献标志码:
A
摘要:
目的：探讨心功能分级（NYHA）、外周血微小RNA208a（miRNA208a）、NOD样受体家族含吡啉结构域蛋白3（NLRP3）水平及心率变异性（HRV）与射血分数减低型心力衰竭（HFrEF）患者不良预后结局的关系。方法：选取115例HFrEF患者作为研究对象，根据随访2年结果是否发生不良心血管事件（MACE），将其分为不良事件组43例、对照组72例，通过查阅两组的病案资料，对比分析两组NYHA、外周血miRNA208a、NLRP3水平、HRV及一般资料差异，通过构建多因素Logistic回归模型分析各项因素与不良结局之间的关系，并绘制预测性受试者工作特征曲线（ROC）。结果：不良事件组患者外周血miRNA208a表达强度、NLRP3蛋白表达强度、NYHA分级达到Ⅳ级的占比均显著高于对照组，不良事件组正常心搏间期标准差（SDNN）、24 h内各5 min段均值的标准差（SDANN）测定值均显著低于对照组，差异具有统计学意义（均P<0.05）；不良事件组低蛋白血症患者占比、外周血N端脑利钠肽前体（NTproBNP）测定值显著高于对照组，差异具有统计学意义（均P<0.05）；Logistic回归结果：HFrEF患者年龄越大、SDNN越小、合并冠心病、外周血miRNA208a高表达、NLRP3蛋白高表达、NYHA分级Ⅳ级是不良预后的危险因素（均P<0.05），预测HFrEF患者不良预后的曲线下面积为AUC=0.885，95%CI：0.831～0.939。结论：NYHA越高，外周血miRNA208a、NLRP3高表达，HRV越突出会增大HFrEF患者不良预后结局的危险，各项因素结合构建的多因素模型对不良预后发生具有较高的预测价值。
Abstract:
Objective:To explore the relationship between cardiac function classification,peripheral blood microrNA208a （miRNA208a）,nucleotidebinding oligomerization domainlike receptor family member （NLRP3） levels,heart rate variability and poor prognosis outcomes in patients with heart failure with reduced ejection fraction （HFrEF）.Methods：A total of 115 patients diagnosed with HFrEF in our hospital from May 2020 to May 2023 were selected as the research subjects.According to whether adverse cardiovascular events （MACE） occurred in the 2year followup results,they were divided into 43 cases in the adverse event group and 72 cases in the control group.By reviewing the medical record data of the two groups,The differences in cardiac function classification （NYHA）,peripheral blood miRNA208a,NLRP3 levels,heart rate variability and general data between the two groups were compared and analyzed.The relationship between each factor and adverse outcomes was analyzed by constructing a multivariate Logistic regression model,and the predictive receiver function curve （ROC） was drawn.Results:The average age of patients in the adverse event group was higher than that in the control group,and the proportion of patients with coronary heart disease in the adverse event group was significantly higher than that in the control group.The differences were statistically significant （all P<0.05）.The expression intensity of miRNA208a in peripheral blood,the expression intensity of NLRP3 protein,and the proportion of patients with NYHA grade IV in the adverse event group were significantly higher than those in the control group.The measured values of SDNN and SDANN in the adverse event group were significantly lower than those in the control group,and the differences were statistically significant （all P<0.05）.The proportion of patients with hypoproteinemia and the measured value of peripheral blood NTproBNP in the adverse events group were significantly higher than those in the control group,and the differences were statistically significant （all P<0.05）.The results of the Logistic regression model showed that the older the age of HFrEF patients,the smaller the SDNN,combined coronary heart disease,high expression of miRNA208a in peripheral blood,high expression of NLRP3 protein,and NYHA grade IV were risk factors for poor prognosis （all P<0.05）.The area under the curve （AUC） of the Logistic regression model for predicting poor prognosis in patients with HFrEF was 0.885,with a 95%CI of 0.831 to 0.939.Conclusion:The higher the cardiac function classification,the higher the expression of miRNA208a and NLRP3 in peripheral blood,and the more prominent the heart rate variability will increase the risk of adverse prognosis in patients with HFrEF.The multifactor model constructed by combining various factors has a high predictive value for the occurrence of adverse prognosis.

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备注/Memo

备注/Memo:
陕西省自然科学基础研究计划项目（2023JCQN0891）
更新日期/Last Update: 2026-04-05