血清微小RNA-21-5p与相关生物标志物对阵发性心房颤动射频消融复发的预测  

Prediction of serum microRNA-21-5p and related biomarkers for recurrence of paroxysmal atrial fibrillation after radiofrequency ablation

作　　者：李振莲 史苏娜 杨柳 任振芳 朱凌凌 LI Zhen-lian;SHI Su-na;YANG Liu;REN Zhen-fang;ZHU Ling-ling(Department of cardiovascular medicine,Xingtai Third Hospital,Xingtai 054000,China)

机构地区：[1]邢台市中心医院心血管内科,河北省邢台市054000

出　　处：《中国心血管病研究》2024年第7期623-628,共6页Chinese Journal of Cardiovascular Research

基　　金：邢台市科技局重点研发计划项目(2021ZC107)。

摘　　要：目的分析微小RNA(miR)-21-5p与血清C反应蛋白(CRP)、B型利钠肽(BNP)、中性粒细胞/淋巴细胞(N/L)、D-二聚体(D-D)对阵发性心房颤动(房颤)患者射频消融复发的预测价值。方法选择2020年1月至2021年1月邢台市中心医院心血管内科收治的120例首次行射频消融术的阵发性房颤患者作为本次的研究对象,根据随访时是否复发分为复发组50例,未复发组70例,另招募同期健康志愿者60例成立对照组,比较各组患者miR-21-5p与炎性因子水平,并分析两者之间的相关性,探究其对阵发性房颤患者射频消融复发的预测价值。结果复发组及未复发组患者血清miR-21-5p水平显著高于对照组,复发组患者血清miR-21-5p水平显著高于未复发组(F=1079.07,P<0.05)。复发组及未复发组患者血清CRP、BNP、N/L水平显著高于对照组,且复发组显著高于未复发组;复发组及未复发组患者血清D-二聚体水平显著低于对照组,且复发组更低;复发组与未复发组左心房前后径(LAD)、舒张早期二尖瓣口血流速度峰值/环根部侧壁运动速度峰值(E/Ea)数值显著高于对照组,且复发组显著高于未复发组[(35.37±2.76)mm比(34.18±2.54)mm比(33.26±2.32)mm,P<0.05];但复发组与未复发组左心房射血分数(LAEF)和收缩期左心房峰值应变率(LASRs)显著低于对照组,复发组更低[LAEF:(0.34±0.08)比(0.48±0.09)比(0.57±0.09),LASRs(1.64±0.37)/s比(1.98±0.43)/s比(3.53±0.51)/s,P<0.05];多因素logistic回归分析提示,D-二聚体、BNP、LAD、E/Ea比值升高是持续性房颤复发的独立危险因素;Pearson法分析阵发性房颤患者血清miR-21-5p水平与CRP、N/L、BNP呈正相关,而与D-二聚体呈负相关(r=0.423,0.271,-0.412,0.325,P均<0.05);受试者工作特征曲线(ROC)研究结果可知,血清miR-21-5p相对表达水平AUC为0.924。血清CRP、BNP、N/L、D-二聚体AUC分别为0.823、0.815、0.733、0.685(P<0.05)。结论血清miR-21-5p在阵发性房颤射频消融复发患者中�Objective To explore the predictive value of microRNA-21-5p and serum C-reactive protein(CRP),B-type natriuretic peptide(BNP),neutrophils/lymphocytes(N/L)and D-dimer(D-D)for recurrence of atrial fibrillation(AF)after radiofrequency ablation in patients with paroxysmal atrial fibrillation.Methods 120 paroxysmal atrial fibrillation patients who underwent first-time radiofrequency ablation in the Cardiovascular Department of Xingtai Central Hospital from January 2020 to January 2021 were selected as the study subjects.According to whether they relapsed during follow-up,they were divided into the relapse group(50 cases)and the non-recurrence group(70 cases),and another 60 healthy volunteers were recruited during the same period as the control group.The levels of miR-21-5p and inflammatory factors in each group were compared,and the correlation between the two was analyzed to explore the predictive value of miR-21-5p in patients with paroxysmal atrial fibrillation.Results The serum miR-21-5p levels of patients in the relapse group and non-recurrence group were significantly higher than that in the control group,and the serum miR-21-5p level of patients in the relapse group was significantly higher than that in the non-recurrence group(F=1079.07,P<0.05).The CRP N/L and BNP levels were significantly higher than those in the control group,and those in the relapsed group were significantly higher than those in the non-relapsed group.The serum D-D levels in the relapse group and non-recurrence group were significantly lower than that in the control group,and the serum D-D level was lower in the relapse group.The values of Left Atrium Diameter(LAD)and the peak value of early diastolic mitral valve flow velocity/the peak value of lateral wall movement velocity of ring root(E/Ea)in the relapsed group and non-relapsed group were significantly higher than those in control group,and those in the relapsed group were significantly higher than those in the non-relapsed group[(35.37±2.76)mm vs.(34.18±2.54)mm vs.(33.26±2.32)mm,P<0

关 键 词：miR-21-5p 血清CRP BNP N/L D-DIMER 阵发性心房颤动 射频消融 相关性分析 

分 类 号：R541.7[医药卫生—心血管疾病]