摘要： 目的 通过研究心房颤动（简称房颤）患者microRNA-328（miRNA-328）的表达水平及左心房内径（LAD）的变化，探讨miRNA-328与房颤患者心房重构的相关性。方法 选取房颤患者120例，分为阵发性房颤（40例）、持续性房颤（48例）、永久性房颤（32例）3个亚组；对房颤患者进行心功能分级，其中Ⅰ级13例，Ⅱ级40例，Ⅲ级36例，Ⅳ级31例。选择同期正常体检者40例作为对照组。采用实时荧光定量PCR检测血清中miRNA-328的表达水平，通过心脏彩色多普勒超声检查测量LAD。结果 与对照组相比，房颤组血清miRNA-328表达水平显著升高（P<0.05）。房颤亚组中，随着房颤持续时间的延长，miRNA-328水平逐渐升高；永久性房颤亚组miRNA-328最高，与阵发性房颤亚组、持续性房颤亚组比较有统计学差异（P<0.05）；但阵发性房颤亚组与持续性房颤亚组比较，miRNA-328表达水平无统计学差异（P>0.05）。房颤组中，血清miRNA-328表达水平与LAD呈正相关（r=0.264，P<0.05），偏相关分析校正后，二者仍呈正相关（r=0.368，P<0.05）。受试者操作特征曲线分析显示，血清miRNA-328的曲线下面积为0.782，95%置信区间为0.689~0.875（P<0.01）。随着心功能分级的增加，房颤患者血清miRNA-328的表达水平升高，不同心功能分级间miRNA-328表达水平的差异均有统计学意义（P<0.05）。结论 miRNA-328可能参与房颤患者的心房重构过程。

microRNA-328与心房颤动患者心房重构的相关性

刘兆奕¹, 吴桂平¹, 林瑶瑶², 赵红丽¹, 张晓丹¹

1. 沈阳医学院附属第二医院心血管内科, 沈阳 110002;
2. 沈阳医学院研究生院, 沈阳 110002

收稿日期:2021-02-05出版日期:2022-01-30发布日期:2021-12-30
通讯作者:刘兆奕E-mail:zhaoyi1013@163.com
作者简介:刘兆奕(1977-),女,主任医师,硕士.
基金资助:辽宁省重点研发计划（2018225017）


关键词: microRNA-328, 心房颤动, 心房重构
Abstract: Objective To assess microRNA-328 (miRNA-328) expression levels and left atrial diameter (LAD) changes in patients with atrial fibrillation (AF), and to explore the relationship between miRNA-328 expression levels and atrial remodeling in patients with AF. Methods We divided 120 patients with AF (AF group) into three subgroups:paroxysmal (n=40), persistent (n=48), and permanent (n=32) AF subgroups; moreover, 40 normal controls were included in the control group. Furthermore, 13, 40, 36, and 31 patients with AF had cardiac function grades Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. Serum miRNA-328 expression levels and LAD changes were evaluated using real-time fluorescence quantitative PCR and color Doppler echocardiography, respectively. Results Serum miRNA-328 expression levels were higher in the AF group than in the control group. In addition, miRNA-328 expression was higher in the permanent AF subgroup than in the paroxysmal and persistent AF subgroups. However, there was no significant difference between miRNA-328 expression levels in the paroxysmal and persistent AF subgroups. Partial correlation analysis showed a positive correlation between miRNA-328 expression and LAD changes (r=0.368, P<0.05). Receiver operating characteristic curve analysis showed an area under the curve of serum miRNA-328 expression was 0.782 (95% confidence interval, 0.689-0.875; P<0.01). The cardiac function grade increased with the miRNA-328 expression level, with statistically significant differences in miRNA-328 expression levels among the different grades. Conclusion miRNA-328 may be involved in the process of atrial remodeling in patients with AF.
Key words: microRNA-328, atrial fibrillation, atrial remodeling
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