标题：循环miR-26b水平变化与高血压患者左心室肥厚及心功能的相关性

      作者：范景如，陈子清，黄钦生，梁瑞士，唐元久，郭舜奇    汕头市中心医院(中山大学附属汕头医院)急诊科综合病区，广东 汕头 515031

      卷次： 2021年32卷16期

      【摘要】 目的 研究循环miR-26b水平变化与高血压患者左心室肥厚及心功能的相关性。方法 回顾性分析2019年12月至2020年12月汕头市中心医院诊治的226例高血压患者的临床资料，根据患者循环miR-26b的相对表达量的不同分为miR-26b高水平组(n=110)和miR-26b低水平组(n=116)。测量所有患者的室间隔厚度(VST)、左心室舒张末期内径(LVEDD)、左心室后壁厚度(LVPWT)、左心室射血分数(LVEF)、二尖瓣舒张早期血液流速峰值(E值)及舒张晚期流速峰值(A值)，计算左心室质量指数(LVMI)和E/A值，根据LVMI判断各组患者中的左心室肥厚(LVH)病例数，比较两组患者上述参数和LVH病例数。采用Pearson相关性分析法分析循环miR-26b水平与上述超声参数的相关性，并采用多因素Logistic回归分析法分析高血压患者左心室肥厚的相关危险因素。结果 高水平组患者的LVEF和LVEDD分别为(66.16±6.52)%和(44.37±3.88) mm，与低水平组的(65.78±6.49)%和(44.54±3.92) mm比较差异均无统计学意义(P>0.05)；高水平组患者的VST、LVPWT、LVMI及 LVH病例数分别为(9.94±0.95) mm、(9.56±0.93) mm、(110.40±10.73) g/cm2和 24例，明显低 (少)于低水平组的 (12.24±1.12) mm、(11.67±1.02) mm、(139.52±12.26) g/cm2和 105例，而E/A值为 0.91±0.28，明显高于低水平组的 0.60±0.13，差异均具有统计学意义(P<0.05)；经 Pearson相关性分析结果显示，循环miR-26b水平与E/A值呈正相关(r=0.264，P<0.05)，与VST、LVPWT、LVMI呈负相关(r=-0.488、-0.519、-0.764，P<0.05)；Logistic分析结果显示，LVPWT及LVMI是高血压左心室肥厚的独立危险因素(OR=3.043、3.183、0.729，P<0.05)，miR-26b水平升高则是保护因素(OR=2.145，P<0.05)。结论 高血压患者的循环miR-26b水平与左心室舒张功能呈正相关，与左心室肥厚状况呈负相关，循环miR-26b水平是高血压患者左心室肥厚的影响因素。
      【关键词】 循环miR-26b；微小RNA；高血压；左心室肥厚；心功能；相关性
      【中图分类号】 R544.1 【文献标识码】 A 【文章编号】 1003—6350（2021）16—2048—04

Correlation between changes in circulating miR-26b levels and left ventricular hypertrophy and cardiac functionin patients with hypertension.
FAN Jing-ru, CHEN Zi-qing, HUANG Qin-sheng, LIANG Rui-shi, TANG Yuan-jiu, GUOShun-qi. General Ward, Emergency Department, Shantou Central Hospital (Shantou Hospital Affiliated to Sun Yat-senUniversity), Shantou 515031, Guangdong, CHINA
【Abstract】 Objective To study the correlation between changes in circulating miR-26b levels and left ventric-ular hypertrophy and cardiac function in patients with hypertension. Methods The clinical data of 226 hypertensive pa-tients diagnosed and treated in Shantou Central Hospital from December 2019 to December 2020 were retrospectivelyanalyzed. The patients were grouped according to the median expression level of miR-26b: high-level group (n=110)and low-level group (n=116). The ventricular septal thickness (VST), left ventricular end diastolic diameter (LVEDD),left ventricular posterior wall thickness (LVPWT) , left ventricular ejection fraction (LVEF), the peak blood flow veloci-ty in the early diastole (E value), and the peak flow velocity in the late diastole (A value) of the mitral valve were mea-sured for all patients. The left ventricular mass index (LVMI) and E/A value were calculated. The number of left ventricu-lar hypertrophy (LVH) cases in each group was judged according to LVMI, and the above parameters and the number ofLVH cases were compared between the two groups of patients. Pearson test was used to analyze the correlation between cir-culating miR-26b level and the above-mentioned ultrasound parameters, and multivariate Logistic regression analysis wasused to analyze the related risk factors of left ventricular hypertrophy in hypertensive patients. Results The LVEF andLVEDD of the high-level group were (66.16±6.52)% and (44.37±3.88) mm, compared with (65.78±6.49)% and (44.54±3.92) mm in the low-level group (P>0.05). The number of VST, LVPWT, LVMI, and LVH cases in the high-level groupwere (9.94±0.95) mm, (9.56±0.93) mm, (110.40±10.73) g/cm2, and 24 cases, which were significantly lower than (12.24±1.12) mm, (11.67±1.02) mm, (139.52±132.26) g/cm2, and 105 cases in the low-level group; the E/A value of the high-levelgroup was 0.91±0.28, which was significantly higher than 0.60±0.13 of the low-level group; the differences were statisticallysignificant (P<0.05). Pearson correlation analysis showed that circulating miR-26b level was positively correlated with E/A(r=0.264, P<0.05), and negatively correlated with VST, LVPWT, and LVMI (r=-0.488, -0.519, -0.764, P<0.05). Logistic