非瓣膜病心房颤动患者循环miRNA-RNA-21水平及应用价值初平及应用价值初探  

A Pilot study of circulating miRNA-21 in patients with non-valvular atrial fibrillation

作　　者：万槐斌 陈冬冬[2] 边宁[2] 吴智豪 列镇邦 WAN Huai-Bin;CHEN Dong-Dong;BIAN Ning;WU Zhi-Hao;LIE Zhen-Bang(Department of Cardiology,Dongguan people’s hospital,Southern Medical University,Dongguan 523059,China;Department of Cardiology,the First Affiliated Hospital,Jinan University,Guangzhou 510630,China)

机构地区：[1]东莞市人民医院南方医科大学附属东莞人民医院心血管内科,广东省东莞市523059 [2]暨南大学附属第一医院心血管内科

出　　处：《中国心血管病研究》2021年第3期214-218,共5页Chinese Journal of Cardiovascular Research

基　　金：广东省医学科学研究基金资助项目(A2017007)。

摘　　要：目的探索非瓣膜病心房颤动患者循环miRNA-21的水平及可能的应用价值。方法前瞻性筛选2017年5月至2018年1月暨南大学附属第一医院心血管内科连续收治的非瓣膜病心房颤动患者,收集患者的人口学特征和病史等资料。根据房颤防治指南方法计算CHA_(2)DS_(2)-VASc评分,并分为高卒中风险组[CHA_(2)DS_(2)-VASc评分≥2分(男性)或≥3分(女性)]和低卒中风险组[CHA_(2)DS_(2)-VASc评分0-1分(男性)或0-2分(女性)]。采集患者空腹外周静脉血,ELISA法检测NT-pro BNP;q RT-PCR法检测循环miRNA-21水平。评估miRNA-21水平与CHA_(2)DS_(2)-VASc评分和NT-pro BNP之间的相关性,ROC曲线验证miRNA-21对高卒中风险的预测价值。结果共入选患者89例,高卒中风险患者41例(46.1%),CHA_(2)DS_(2)-VASc中位评分4(2.5~5.5)分。高卒中风险组与低卒中风险组血常规、肝肾功能和NT-pro BNP等无显著差异;高卒中风险组循环miRNA-21表达量较低卒中风险组显著升高[4.59(2.91-5.33)比1.71(1.48-3.04),P<0.001]。Pearson相关分析显示循环miRNA-21表达量与CHA_(2)DS_(2)-VASc评分(r=0.461,P=0.002)和NT-pro BNP(r=0.386,P=0.013)均显著相关。ROC曲线分析提示循环miRNA-21表达量对高卒中风险具有较高预测价值(AUC=0.843,P<0.001)。结论循环miRNA-21可能用于预测非瓣膜病心房颤动患者高卒中风险。Objective To explore the level and significance of circulating mi RNA-21 in patients with nonvalvular atrial fibrillation(NVAF).Methods A study of prospectively enrolled consecutive patients with NVAF admitted to the Dept.of Cardiology,the First Affiliated Hospital,Jinan University was conducted between May 2017 and Jan 2018.The demographic characteristics and medical histories were collected.CHA_(2)DS_(2)-VASc score was calculated according to clinical guidelines and patients were divided into high risk of stroke[CHA_(2)DS_(2)-VASc score≥2(male)or≥3(female)]and low risk group[CHA_(2)DS_(2)-VASc score 0-1(male)or 0-2(female)].The fasting peripheral venous blood was drawn for biomarkers detection.NT-pro BNP was tested by the ELISA assay and circulating mi RNA-21 was determined by q RT-PCR.The predictive value of mi RNA-21 was assessed by ROC curve.Results A total of 89 patients were enrolled.41 patients(46.1%)were at high risk of stroke and the median CHA_(2)DS_(2)-VASc score was 4(2.5-5.5.There was no significant difference in blood routine test,liver and renal function and NT-pro BNP between the patients at high risk of stroke and those at low risk of stroke.However,circulating mi RNA-21 levels were significantly increased in patients at high risk of stroke(P<0.001).Pearson analysis showed that circulating mi RNA-21 levels were significantly correlated with CHA_(2)DS_(2)-VASc score(r=0.461,P=0.002)and NT-pro BNP(r=0.386,P=0.013).ROC analysis indicated that circulating mi RNA-21 levels were of more value to predict the risk of stroke with an AUC 0.843(P<0.001).Conclusions Circulating mi RNA-21 level might be a valuable biomarker to predict the risk of stroke in patients with NVAF.

关 键 词：心房颤动 脑卒中 血栓栓塞 MIRNA-21 

分 类 号：R541.4[医药卫生—心血管疾病]