外周血微小RNA-216a与小儿病毒性心肌炎的相关性研究  

Correlation between Peripheral Blood miRNA-216a and Viral Myocarditis in Children

作　　者：施帅[1] 赵佳 白晓鹏[1] 李学奇[1] 孙超宇[1] SHI Shuai;ZHAO Jia;BAI Xiaopeng;LI Xueqi;SUN Chaoyu(Department of Cardiology,the Fourth Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第四医院心内科

出　　处：《实用心脑肺血管病杂志》2019年第6期35-39,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：黑龙江省卫生计生委科研课题(2016-124)

摘　　要：背景 病毒性心肌炎主要由柯萨奇病毒B3(CVB3)感染引起,而微小RNA(miRNAs)与CVB3感染密切相关,因此明确miRNAs与小儿病毒性心肌炎的关系可能为临床诊治小儿病毒性心肌炎患儿提供新思路。目的 探讨外周血miRNA-216a与小儿病毒性心肌炎的相关性。方法 选取2018年1月—2019年1月哈尔滨医科大学附属第四医院收治的疑似病毒性心肌炎患儿38例,其中确诊为病毒性心肌炎患儿30例(观察组),另选取同期体检健康儿童30例作为对照组。比较两组儿童外周血miRNA-216a表达量及血清心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平,外周血miRNA-216a表达量与病毒性心肌炎患儿住院时间、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及血清cTnI、CK-MB水平间的相关性分析采用Pearson相关分析;绘制受试者工作特征(ROC)曲线以评价外周血miRNA-216a表达量及血清cTnI、CK-MB水平对小儿病毒性心肌炎的诊断价值。结果 (1)观察组患儿外周血miRNA-216a表达量及血清cTnI、CK-MB水平高于对照组(P<0.05)。(2)Pearson相关分析结果显示,外周血miRNA-216a表达量与病毒性心肌炎患儿住院时间(r=0.409)、APACHEⅡ评分(r=0.607)及血清cTnI(r=0.491)、CK-MB(r=0.472)水平呈正相关(P<0.05)。(3)ROC曲线显示,外周血miRNA-216a表达量诊断小儿病毒性心肌炎的曲线下面积(AUC)为0.662,血清cTnI水平为0.705,血清CK-MB水平为0.678。结论 外周血miRNA-216a表达量与小儿病毒性心肌炎及其病情严重程度、心肌损伤程度有关,且其对小儿病毒性心肌炎的诊断价值与血清cTnI、CK-MB水平相似。Background Viral myocarditis is mainly caused by coxsackievirus B3(CVB3)infection,while miRNAs is closely correlated with CVB3 infection,so explaining the relationship between miRNAs and viral myocarditis in children may provide a new idea for diagnosing and treating viral myocarditis in children. Objective To investigate the correlation between peripheral blood miRNA-216a and viral myocarditis in children. Methods From January 2018 to January 2019,a total of 38 suspected children with viral myocarditis were selected in the Fourth Affiliated Hospital of Harbin Medical University,in which 30 cases were diagnosed viral myocarditis as observation group,meanwhile a total of 30 healthy children admitted to this hospital for physical examination were selected as control group. Peripheral blood miRNA-216a expression quantity,serum levels of cTnI and CK-MB were compared between the two groups,correlations of peripheral blood miRNA- 216a expression quantity with hospital stays,APACHE Ⅱ score,serum levels of cTnI and CK-MB in children with viral myocarditis were analyzed by Pearson correlation analysis;ROC curve was drawn to evaluate the diagnostic value of peripheral blood miRNA-216a expression quantity,serum levels of cTnI and CK-MB in diagnosing viral myocarditis in children. Results (1)Peripheral blood miRNA-216a expression quantity,serum levels of cTnI and CK-MB in observation group were statistically significantly higher than those in control group(P<0.05).(2)Pearson correlation analysis results showed that, peripheral blood miRNA-216a expression quantity was significantly positively correlated with hospital stays(r=0.409),APACHE Ⅱ score(r=0.607),serum levels of cTnI(r=0.491)and CK-MB(r=0.472)in children with viral myocarditis, respectively(P<0.05).(3)ROC curve showed that,AUC of peripheral blood miRNA-216a expression quantity was 0.662 in diagnosing viral myocarditis in children,that of serum cTnI level was 0.705,and that of serum CK-MB level was 0.678. Conclusion Peripheral blood miRNA-216a expression quantity

关 键 词：心肌炎 病毒感染 微小RNA-216a 肌钙蛋白I 肌酸激酶同工酶 心肌损伤 诊断 

分 类 号：R542.21[医药卫生—心血管疾病]