心电图QRS波时限联合血清微小RNA-181b、微小RNA-146a可有效诊断扩张型心肌病患者心力衰竭

王夏莉.心电图QRS波时限联合血清微小RNA-181b、微小RNA-146a可有效诊断扩张型心肌病患者心力衰竭[J].内科急危重症杂志,2025,31(6):536-539

DOI：10.11768/nkjwzzzz20250610

中文关键词: 心电图QRS波时限微小RNA-181b 微小RNA-146a 扩张型心肌病心力衰竭

英文关键词:

基金项目:

作者	单位	E-mail
王夏莉	西安医学院第二附属医院	syy202405@163.com

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中文摘要:

摘要目的：探讨心电图QRS波时限联合血清微小RNA（miR）-181b、miR-146a对扩张型心肌病（DCM）患者心力衰竭（HF）的评估价值。方法：选取DCM合并HF患者198例为研究组，另选取同期在本院治疗的DCM患者198例为对照组。采用实时荧光定量逆转录聚合酶链反应(qRT-PCR)法测定血清miR-181b、miR-146a水平；采用多因素Logistic回归分析DCM合并HF的影响因素；采用受试者工作特征（ROC）曲线分析心电图QRS波时限联合血清miR-181b、miR-146a水平对DCM合并HF的诊断价值。结果：与对照组比较，研究组左心室射血分数、血清miR-181b水平更低；N末端B型利钠肽原（NT-proBNP）、miR-146a水平更高；心电图QRS波时限增加（P均＜0.05）。Logistic回归分析显示，血清miR-181b是影响DCM患者发生HF的保护因素；而血清miR-146a、NT-proBNP、QRS波时限是其危险因素（P均＜0.05）。血清miR-181b、miR-146a及QRS波时限三者联合诊断DCM患者HF的曲线下面积（AUC）最高，优于三者单独诊断（Z三者联合-miR-181b=6.234、P＜0.001，Z三者联合-miR-146a=3.218、P=0.001，Z三者联合-QRS波时限=5.742、P＜0.001）。结论：血清miR-181b、miR-146a、QRS波时限三者联合可更好诊断DCM患者HF发生。

英文摘要:

Abstract Objective: To explore the evaluation value of electrocardiogram QRS wave duration combined with serum microRNA(miR)-181b and miR-146a for heart failure (HF) in patients with dilated cardiomyopathy (DCM). Methods: A total of 198 patients with DCM combined with HF were selected as the research group, while 198 patients with DCM who were treated in our hospital during the same period were selected as the control group. The expression levels of serum miR-181b and miR-146a were measured using quantiative reverse transcription polymerase chain(qRT-PCR). The influencing factors of DCM complicated with HF were analyzed using multivariate logistic regression. Receiver operating characteristic(ROC) curve was applied to analyze the diagnostic value of electrocardiogram QRS wave duration combined with serum miR-181b and miR-146a levels for DCM complicated with HF. Results: The left ventricular ejection fraction and serum miR-181b level in the research group were lower, and the levels of N-terminal B-type natriuretic peptide (NT-proBNP) and miR-146a were higher than in the control group. The time limit of QRS wave in ECG increased (all P< 0.05). Logistic regression analysis showed that serum miR-181b was the protective factor of HF in DCM patients, while serum miR-146a, NT-proBNP and QRS wave duration were the risk factors (all P< 0.05). The AUC of serum miR-181b, miR-146a and QRS wave duration in the diagnosis of HF in DCM patients was the greatest, which was greater than that of the three methods alone (Zcombination - miR-181b=6.234, P< 0.001; Zcombination - miR-146a= 3.218, P= 0.001; Zcombination - QRS wave duration= 5.742, P<0.001). Conclusion: The combination of serum miR-181b, miR-146a and QRS wave duration can better diagnose the occurrence of HF in DCM patients.