[1]李晶晶,刘晓晨,刘恩香,等.心房颤动患者血清miR-29b 和miR-135b 水平表达与心房纤维化程度及射频消融术后复发的相关性研究[J].现代检验医学杂志,2023,38(06):75-80.[doi:10.3969/j.issn.1671-7414.2023.06.014]
　LI Jingjing,LIU Xiaochen,LIU Enxiang,et al.Correlation between the Expression of miR-29b and miR-135b in Serum of Patients with Atrial Fibrillation and the Degree of Atrial Fibrosis and the Recurrence after Radiofrequency Ablation[J].Journal of Modern Laboratory Medicine,2023,38(06):75-80.[doi:10.3969/j.issn.1671-7414.2023.06.014]
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心房颤动患者血清miR-29b 和miR-135b 水平表达与心房纤维化程度及射频消融术后复发的相关性研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
75-80
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Correlation between the Expression of miR-29b and miR-135b in Serum of Patients with Atrial Fibrillation and the Degree of Atrial Fibrosis and the Recurrence after Radiofrequency Ablation
文章编号:
1671-7414（2023）06-075-06
作者:
李晶晶; 刘晓晨; 刘恩香; 王岳胜
（沧州市人民医院心血管内科，河北沧州 061000）
Author(s):
LI Jingjing; LIU Xiaochen; LIU Enxiang; WANG Yuesheng
（Department of Cardiovascular Medicine, Cangzhou People’s Hospital, Hebei Cangzhou 061000, China）
关键词:
心房颤动; 微小核糖核酸-29b; 微小核糖核酸-135b; 射频消融术
分类号:
R541.75；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.014
文献标志码:
A
摘要:
目的 观察心房颤动（atrial fibrillation，AF）患者血清微小核糖核酸（micro RNA，miRNA，miR）-29b 和miR-135b 的表达变化，探讨二者表达与心房纤维化程度及射频消融术后复发的关系。方法 选取2019 年7 月～ 2022年7 月于沧州市人民医院心血管内科住院诊治并接受射频消融术治疗的AF 患者（病例组，n=158）以及同期体检的健康者（对照组，n=126）。收集AF 患者的一般临床资料及生化指标，采用实时荧光定量PCR 法检测血清miR-29b 和miR-135b 相对表达水平。采用多因素Logistic 回归分析AF 患者术后复发的影响因素；绘制受试者工作特征（receiveroperating characteristic，ROC）曲线分析血清miR-29b 和miR-135b 水平对AF 患者术后复发的预测价值，曲线下面积（area under the curve，AUC）比较采用Z 检验。结果 与对照组比较，病例组血清miR-29b（0.64±0.13 vs 1.04±0.24）和miR-135b 水平（0.45±0.08 vs 1.00±0.14）均降低，差异均有统计学意义（t=17.916，41.604，均P<0.05）；与低纤维化组比较，高纤维化组血清miR-29b（0.51±0.11 vs 0.76±0.15）和miR-135b 水平（0.34±0.07 vs 0.55±0.09）均降低，差异有统计学意义（t=11.896，16.314，均P<0.05）。与未复发组比较，复发组左心房内径（45.34±3.56 mm vs35.23±2.89 mm）和血清尿酸（uric acid，UA）水平（478.15±68.45 μmol/L vs 421.75±61.76 μmol/L）均升高，血清miR-29b（0.54±0.12 vs 0.72±0.14）和miR-135b 水平（0.36±0.06 vs 0.53±0.10）均降低，差异有统计学意义（t=19.702，5.441，8.584，12.642，均P<0.05）。Logistic 回归分析显示，左心房直径（OR=1.603，95%CI：1.054 ～ 2.439），UA（OR=1.527，95%CI：1.202 ～ 1.939），miR-29b（OR=0.657，95%CI：0.515 ～ 0.835）和miR-135b（OR=0.318，95%CI：0.141 ～ 0.719）水平是影响AF 患者术后复发的影响因素（均P<0.05）；血清miR-29b 和miR-135b 预测AF 患者射频消融术后复发的AUC 分别为0.843（95%CI：0.783 ～ 0.902），0.901（95%CI：0.852 ～ 0.949），最佳阈值分别为0.43 和0.64，灵敏度分别为65.1% 和80.2%，特异度分别为88.9% 和91.7%，两者联合预测术后复发的AUC为0.947（95%CI：0.914 ～ 0.981），灵敏度和特异度分别为90.75%，83.1%。结论 血清miR-29b 和miR-135b 水平异常表达与AF 患者心房纤维化程度及射频消融术后复发有关，二者联合预测AF 患者术后复发具有一定的价值。
Abstract:
Objective To observe the changes of serum micro RNA(miR)-29b and miR-135b expression in patients with atrial fibrillation (AF), and explore the relationship between their expression and the degree of atrial fibrosis and recurrence after radiofrequency ablation. Methods A total of 158 patients with AF hospitalized in the Department of Cardiovascular Medicine of Cangzhou People’s Hospital from July 2019 to July 2022 and treated with radiofrequency ablation (case group) and 126 healthy people who underwent physical examination meantime (control group) were selected， the general clinical data and biochemical indexes of AF patients were collected, and the relative expression levels of miR-29b and miR-135b in serum were detected by real-time fluorescence quantitative PCR. Multivariate Logistic regression was used to analyze the influencing factors of postoperative recurrence in AF patients. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum miR-29b and miR-135b levels for postoperative recurrence in AF patients. Area under the curve(AUC) was compared using Z test. Results Compared with the control group, the levels of miR-29b (0.64±0.13 vs 1.04±0.24) and miR-135b (0.45±0.08 vs 1.00±0.14) in the case group decreased, and the differences were statistically significant (t=17.916, 41.604，all P<0.05). Compared with low fibrosis group, serum miR-29b (0.51±0.11 vs 0.76±0.15) and miR-135b levels (0.34±0.07 vs 0.55±0.09) in patients with high fibrosis were decreased, and the differences were statistically significant (t=11.896, 16.314, all P<0.05). Compared with the non-relapsed group, the left atrial diameter (45.34±3.56mm vs 35.23±2.89mm) and serum UA level (478.15±68.45μmol/L vs 421.75±61.76μmol/L) in the relapsed group increased, serum miR-29b (0.54±0.12 vs 0.72±0.14), miR-135b level (0.36±0.06 vs 0.53±0.10) were decreased, the difference were statistically significant (t=19.702, 5.441, 8.584, 12.642, all P<0.05). Logistic regression analysis showed that left atrial diameter (OR=1.603, 95%CI: 1.054 ～ 2.439), UA (OR=1.527, 95%CI: 1.202 ～ 1.939), miR-29b (OR=0.657, 95%CI: 0.515 ～ 0.835), and miR-135b (OR=0.318, 95%CI: 0.141 ～ 0.719) levels were the influencing factors for postoperative recurrence in AF patients (all P<0.05). The AUC of serum miR-29b and miR-135b in predicting the recurrence of AF patients after radiofrequency ablation were 0.843 (95%CI: 0.783 ～ 0.902) and 0.901 (95%CI: 0.852 ～ 0.949), the optimal threshold was 0.43 and 0.64, the sensitivity was 65.1% and 80.2%, and the specificity was 88.9% and 91.7%, respectively. The AUC of postoperative recurrence predicted by the combination of the two methods was 0.947 (95%CI: 0.914 ～ 0.981), the sensitivity and the specificity was 90.75%, 83.10%, respectively. Conclusion Abnormal expression of serum miR-29b and miR-135b levels was related to the degree of atrial fibrosis and the recurrence after radiofrequency ablation in AF patients, and the combination of the two has certain value in predicting postoperative recurrence in AF patients.

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相似文献/References:

[1]温旭涛,杨希立,舒建坤,等.术前血清可溶性ST2水平对心房颤动射频消融术后复发的预测价值研究[J].现代检验医学杂志,2022,37(03):191.[doi:10.3969/j.issn.1671-7414.2022.03.040]
　WEN Xu-tao,YANG Xi-li,SHU Jian-kun,et al.Value of Preoperative Serum Soluble ST2 Level in Predicting Recurrence of Atrial Fibrillation after Radiofrequency Ablation[J].Journal of Modern Laboratory Medicine,2022,37(06):191.[doi:10.3969/j.issn.1671-7414.2022.03.040]

备注/Memo

备注/Memo:
基金项目： 河北省卫生健康委科研基金项目（编号：20200292）：房颤射频消融术后复发的多因素分析。
作者简介： 李晶晶（1989-），女，硕士研究生，主治医师，研究方向：心内科常见疾病及多发病，E-mail：lll7n3@sina.com。
通讯作者： 刘晓晨（1981-），男，硕士研究生，副主任医师，研究方向：心内科常见病以及心律失常介入治疗，E-mail：lxc13463726331@163.com。
更新日期/Last Update: 2023-11-15