心律失常合并医院感染患者外周血miR-126-5p和miR-133a表达水平  

Expression of peripheral blood miR-126-5p and miR-133a in arrhythmia patients complicated with nosocomial infection

作　　者：徐娜 崔云飞 叶玲 高卓琍 蒲敏 XU Na;CUI Yun-fei;YE Ling;GAO Zhuo-li;PU Min(Qingdao Hospital of Traditional Chinese Medicine(Haici Hospital),Qingdao,Shandong 266000,China)

机构地区：[1]青岛市中医医院(青岛市海慈医院)心血管内科,山东青岛266000 [2]青岛市中医医院(青岛市海慈医院)肝胆内科,山东青岛266000

出　　处：《中华医院感染学杂志》2022年第5期708-712,共5页Chinese Journal of Nosocomiology

基　　金：青岛市科技局基金资助项目(k091220)。

摘　　要：目的 探究心律失常合并医院感染患者外周血微小RNA(miR)-126-5p、miR-133a表达变化。方法 选取2019年1月-2020年12月青岛市中医医院治疗的76例心律失常合并医院感染患者为研究对象,比较患者感染前后心电图特点、心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)]、炎症因子[C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、外周血miR-126-5p、miR-133a水平的变化。结果 感染后室性期前收缩、房性期前收缩和窦性心动过速发生率高于感染前(P<0.05),感染前后束支传导阻滞、心房纤颤、窦性心动过缓及房室传导阻滞发生率比较,无统计学差异。感染后患者血清CK、CK-MB、CRP、IL-6、TNF-α、外周血miR-126-5p及miR-133a水平高于感染前(P<0.05),感染前后AST和LDH水平比较,无统计学差异。受试者工作特征曲线(ROC)分析结果显示,miR-126-5p、miR-133a及联合对心律失常者发生医院感染的曲线下面积(AUC)分别为0.742、0.787、0.823,其中联合检测AUC高于单独检测miR-126-5p(P<0.05)。结论 心律失常患者发生医院感染后心电图和心肌酶谱有明显变化,且外周血miR-126-5p、miR-133a水平异常升高,通过监测上述指标的变化可较好地防治心律失常合并医院感染。OBJECTIVE To explore the changes of expression levels of peripheral blood microRNA(miR-126-5 p, miR-133 a) in arrhythmia patients complicated with nosocomial infection. METHODS A total of 76 arrhythmia patients complicated with nosocomial infection who were treated in Qingdao Hospital of Traditional Chinese Medicine from Jan 2019 to Dec 2020 were recruited as the study subjects. The characteristics of electrocardiogram, myocardial enzyme spectrum [creatine kinase(CK), creatine kinase isoenzyme(CK-MB), aspartate aminotransferase(AST), lactate dehydrogenase(LDH)], inflammatory factors [C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] and peripheral blood miR-126-5 p and miR-133 a levels were observed and compared before and after the patients had infection. RESULTS The incidence rates of ventricular premature contraction, atrial premature contraction and sinus tachycardia were significantly higher after the infection than before the infection(P<0.05);there were no significant differences in the incidence rates of bundle branch block, atrial fibrillation, sinus bradycardia and atrioventricular block before and after the infection. The levels of serum CK, CK-MB, CRP, IL-6, TNF-α, peripheral blood miR-126-5 p and miR-133 a were significantly higher after the infection than before the infection(P<0.05);there were no significant differences in the levels of AST and LDH before and after the infection. The receiver operating characteristic(ROC) curve analysis showed that the areas under curves(AUC) of miR-126-5 p, miR-133 a and their combination were respectively 0.742, 0.787 and 0.823 for the arrhythmia patients comoplicated with nosocomial infection, and the AUC of the combination was significantly higher than that of the single detection of miR-126-5 p(P<0.05). CONCLUSION There are significant changes of electrocardiogram and myocardial enzyme spectrum in the arrhythmia patients complicated with nosocomial infection, and the levels of peripheral blood miR-126-5 p and miR-133 a are abnorm

关 键 词：心律失常 医院感染 miR-126-5p miR-133a 心电图 心肌酶谱 

分 类 号：R541.7[医药卫生—心血管疾病]