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

doi:10.3969/j.issn.1006-6233.2023.07.011

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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。

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关键词 ：病毒性心肌炎, 心肌酶学, miR-26b, miR-19b

Abstract：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 expression levels of ALT,AST,LDH,cTnI,CK-MB,CK and miR-19b in patients with poor prognosis were higher than those in patients with good prognosis,and the difference was statistically significant (P<0.05); the relative expression intensity of miR-26b in patients with poor prognosis was lower than that in patients with good prognosis,and the difference was statistically significant (P<0.05); the results of logistic regression analysis showed that atrial flutter/atrial fibrillation,atrioventricular block,bundle branch block,increased ALT,AST,LDH,cTnI,CK-MB,CK,miR-19b and miR-26b were independent risk factors for poor prognosis in patients with myocarditis (P<0.05). Conclusion: In patients with viral myocarditis,peripheral blood myocardial enzymology indexes and miR-19b expression were significantly increased,and miR-26b expression was significantly decreased,which was closely related to poor prognosis of patients.

Key words： Viral myocarditis Myocardial enzymology miR-26b miR-19b

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

引用本文:

王小芳, 林琳, 雷蕾, 鲁红娥, 雷朝, 刘基燕. 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[J]. 河北医学, 2023, 29(7): 1114-1119.
WANG Xiaofang, LIN Lin, LEI Lei, et al. 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. HeBei Med, 2023, 29(7): 1114-1119.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.07.011 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I7/1114

[1] Bollache E,Huber A T,Lamy J,et al.T1 mapping-derived signature of myocardial involvement in idiopathic inflammatory myopathy compared to acute viral myocarditis:a texture-based analysis[J].European Heart Journal - Cardiovascular Imaging,2021,22(1):233-235.
[2] Lu J,Cen Z,Tang Q,et al.The absence of B cells disrupts splenic and myocardial treg homeostasis in coxsackievirus B3-induced myocarditis[J].Clinical and Experimental Immunology,2022,208(1):1-11.
[3] Choi HJ,Kwon HW,Oh KJ,Song MK.Acute perimyocarditis mimicking acute myocardial infarction in a 12-year-old boy with duchenne muscular dystrophy[J].Acute Crit Care,2022,37(2):258-262.
[4] Hou YM,Han PX,Wu X,et al.Myocarditis presenting as typical acute myocardial infarction:a case report and review of the literature[J].World Clin Cases,2020,8(2):415-424.
[5] 梁万前,李建华,白彩艳,等.病毒性心肌炎患者血清sST2、mir-26b表达水平及临床意义[J].中国循证心血管医学杂志,2022,14(5):620-623.
[6] Lasrado N,Borcherding N,Arumugam R,et al.Dissecting the cellular landscape and transcriptome network in viral myocarditis by single-cell RNA sequencing[J].iScience,2022,25(3):e103865.
[7] 陈加辉,何建,戴璐,等.miR-19b-3p在病毒性心肌炎心脏损伤中的作用及机制[J].心电与循环,2022,41(4):369-373.
[8] 《中华心血管病杂志》编辑委员会心肌炎心肌病对策专题组.关于成人急性病毒性心肌炎诊断参考标准和采纳世界卫生组织及国际心脏病学会联合会工作组关于心肌病定义和分类的意见[J].中华心血管病杂志,1999,16(4):307-308.
[9] 朱建峰,李君,黄吕,等.心通颗粒对病毒性心肌炎小鼠炎症反应及心肌损伤的保护作用[J].中华医院感染学杂志,2021,31(21):3216-3220.
[10] 曲艺,张迪,刘亚欣.微小RNA对病毒性心肌炎调控机制的研究进展[J].中国心血管杂志,2021,26(3):303-305.
[11] 钟夕艳,邓国兰,薛雨洲,等.成人重症病毒性心肌炎的相关影响因素分析[J].重庆医科大学学报,2021,46(2):162-165.
[12] 卢东东,唐智奇,杨帆,等.病毒性心肌炎患者外周血miR-146b表达水平与病情及不良预后风险的相关性[J].山西医科大学学报,2022,53(8):998-1003.