病毒性心肌炎患者外周血心肌酶谱和miR-26b miR-19b表达变化分析及与预后的关系  

Analysis of Changes in Myocardial Enzyme Indexes and miR-26b and miR-19b Expression in Peripheral Blood of Patients with Toxic Myocarditis and the Relationship with Prognosis

作　　者：王小芳[1] 林琳[1] 雷蕾[1] 鲁红娥 雷朝 刘基燕 WANG Xiaofang;LIN Lin;LEI Lei(The Second Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710000,China)

机构地区：[1]西安交通大学第二附属医院心血管内科,陕西西安710000 [2]延安大学医学院,陕西延安716000

出　　处：《河北医学》2023年第7期1114-1120,共7页Hebei Medicine

基　　金：陕西省自然科学基金重点研发计划项目,(编号:2019SF-158)。

摘　　要：目的:探讨病毒性心肌炎患者外周血心肌酶学指标、血清微小RNA-26b(miR-26b)、微小RNA-19b(miR-19b)的变化及与患者预后结局的关系。方法:选取我院2020年11月至2022年8月收治的116例病毒性心肌炎患者作为心肌炎组、另外选取同期健康体检的非心肌炎志愿者60例作为对照组,对比两组的心肌酶学指标、血清miR-26b、miR-19b水平,并根据患者随访6个月的预后结局进行分组,对比两组的各项一般资料及研究指标,采用Logistic回归分析影响病毒性心肌炎患者预后结局的相关指标。结果:心肌炎组患者的ALT、AST、LDH、cTnI、CK-MB、CK、miR-19b表达水平高于对照组,差异具有统计学意义(P<0.05);心肌炎组患者的miR-26b相对表达强度低于对照组,差异具有统计学意义(P<0.05);根据6个月随访,预后不良患者36例,其中死亡2例、再次出现心力衰竭入院18例、心律失常入院9例、心肌炎复发7例;预后良好组和预后不良组患者的年龄、BMI、性别、胸痛情况比较,差异无统计学意义(P>0.05);预后不良组的收缩压、舒张压低于预后良好组,预后不良组患者的心率频率、胸闷、心肌、乏力、呼吸频率、房扑/房颤、房室传导阻滞、束支阻滞均高于预后良好组,差异具有统计学意义(P<0.05);预后不良组患者的ALT、AST、LDH、cTnI、CK-MB、CK、miR-19b表达水平高于预后良好组,差异具有统计学意义(P<0.05);预后不良组患者的miR-26b相对表达强度低于预后良好组,差异具有统计学意义(P<0.05);Logistic回归分析结果显示:房扑/房颤、房室传导阻滞、束支阻滞、ALT增高、AST增高、LDH增高、cTnI增高、CK-MB增高、CK增高、miR-19b增高、miR-26b降低是心肌炎患者不良预后结局的独立危险因素(P<0.05)。结论:病毒性心肌炎患者外周血心肌酶学指标及miR-19b表达显著增高、miR-26b表达显著降低,并且与患者不良的预后结局具有密切关系。Objective:To investigate the changes of myocardial enzymology indexes in peripheral blood,serum micrornA-26b(miR-26b),micrornA-19b(miR-19b)and their relationship with prognosis in patients with viral myocarditis.Methods:A total of 116 patients with viral myocarditis admitted to our hospital from November 2020 to August 2022 were selected as the myocarditis group,and 60 cases non-myocarditis volunteers who underwent physical examinations during the same period were selected as the control group.The myocardial enzyme indicators,serum miR-26b,and miR-19b levels of the two groups were compared,and the patients were grouped based on the 6-month follow-up prognosis.The general information and research indicators of the two groups were compared.Logistic regression analysis was used to identify relevant indicators that affected the prognosis of patients with viral myocarditis.Results:The expression levels of ALT,AST,LDH,cTnI,CK-MB,CK,and miR-19b in patients with myocarditis were higher than those in the control group,and the difference was statistically significant(P<0.05);the relative expression intensity of miR-26b in patients with myocarditis was lower than that in the control group,and the difference was statistically significant(P<0.05);according to a 6-month follow-up,there were 36 patients with poor prognosis,including 2 deaths,18 hospitalizations for recurrent heart failure,9 hospitalizations for arrhythmia,and 7 relapses of myocarditis;there was no statistically significant difference in age,BMI,gender and chest pain between the group with good prognosis and the group with poor prognosis(P>0.05);the systolic blood pressure and diastolic blood pressure in the poor prognosis group were lower than those in the good prognosis group,and the heart rate,chest tightness,myocardium,fatigue,respiratory rate,atrial flutter/atrial fibrillation,atrioventricular block and bundle branch block in the poor prognosis group were higher than those in the good prognosis group,with a statistically significant difference(P<0.05);the e

关 键 词：病毒性心肌炎 心肌酶学 miR-26b miR-19b 

分 类 号：R542.21[医药卫生—心血管疾病]