【摘要】 目的 探究非瓣膜性房颤（NVAF）患者外周血REV-ERBα mRNA、miRNA-296-3p表达与心房重构的关系。方法 选择2020年7月至2023年7月于郑州市第七人民医院就诊的NVAF患者262例作为NVAF组，选择同期来本院体检的健康人100名作为对照组。记录两组一般资料及血糖、血脂等实验室指标，并比较两组外周血REV-ERBα mRNA、miRNA-296-3p水平、超声心电图，分析外周血REV-ERBαmRNA、miRNA-296-3p对NVAF的诊断价值。将NVAF患者分成阵发性心房颤动组（n=68）、持续性心房颤动组（n=99）、永久性心房颤动组（n=95），比较三组的外周血REV-ERBα mRNA、miRNA-296-3p水平，分析外周血REV-ERBα mRNA、miRNA-296-3p水平与心房重构指标的关系。结果 NVAF组的REV-ERBαmRNA水平低于对照组，miRNA-296-3p水平高于对照组，差异有统计学意义（P<0.05）;NVAF组的LVEF、LVEDD水平均低于对照组，LAD水平均高于对照组，差异有统计学意义（P<0.05）;ROC曲线分析发现，外周血REV-ERBα mRNA、miRNA-296-3p联合诊断NVAF时的AUC为0.922，高于单一指标的0.856、0.862；三组REV-ERBα mRNA比较：阵发性心房颤动组>持续性心房颤动组>永久性心房颤动组，差异有统计学意义（P<0.05）；三组miRNA-296-3p比较：阵发性心房颤动组<持续性心房颤动组<永久性心房颤动组，差异有统计学意义（P<0.05）;NVAF组患者外周血REV-ERBα mRNA与LVEF、LVEDD成正相关（P<0.05）、与LAD成负相关（P<0.05）,miRNA-296-3p水平与LVEF、LVEDD成负相关（P<0.05）、与LAD成正相关（P<0.05）。结论 NVAF患者的外周血REV-ERBα mRNA水平低于健康人群，miRNA-296-3p水平高于健康人群，两指标与患者病情进展相关，联合检查可为临床诊断提供更多参考。更多还原

【Abstract】 Objective To explore the relationship between peripheral blood REV-ERBα mRNA, miRNA-296-3p and atrial remodeling in patients with non-valvular atrial fibrillation(NVAF). Methods A total of 262 patients with NVAF and 100 healthy controls at the 7th People’s Hospital of Zhengzhou were enrolled as the NVAF group and the control group between July 2020 and July 2023, respectively. General data, blood glucose, blood lipid, and other laboratory indexes were recorded for both groups. The levels of peripheral blood REV-ERBα mRNA and miRNA-296-3p, and ultrasonic electrocardiogram in the two groups were compared.The diagnostic value of peripheral blood REV-ERBα mRNA and miRNA-296-3p for NVAF was analyzed.NVAF patients were further divided into paroxysmal atrial fibrillation group(n=68), persistent atrial fibrillation group(n=99) and permanent atrial fibrillation group(n=95). Levels of peripheral blood REV-ERBα mRNA and miRNA-296-3p were compared among the three groups. The relationship between peripheral blood REV-ERBα mRNA, miRNA-296-3p and atrial remodeling indexes was analyzed. Results The REV-ERBα mRNA level in the NVAF group was lower than that in the control group, while the miRNA-296-3p level was higher than that in the control group( P<0.05). The levels of left ventricular ejection fraction( LVEF) and left ventricular end diastolic diameter( LVEDD) in the NVAF group were lower than those in the control group, while left atrium diameter( LAD) was longer than that in the control group( P<0.05). ROC curve analysis showed that the AUC of REV-ERBα mRNA combined with miRNA-296-3p in diagnosng NVAF was 0.922, higher than that of a single index( 0.856, 0.862). In the paroxysmal atrial fibrillation group, persistent atrial fibrillation group and permanent atrial fibrillation group, the REV-ERBα mRNA level gradually decreased, while the miRNA-296-3p level increased( P<0.05). In the NVAF group, peripheral blood REV-ERBα mRNA was positively correlated with LVEF and LVEDD( P<0.05), while negatively correlated with LAD( P<0.05). The level of miRNA-296-3p was negatively correlated with LVEF and LVEDD(P<0.05), while positively correlated with LAD(P<0.05). Conclusions Compared to healthy individuals, the levels of peripheral blood REV-ERBα mRNA are lower, while the levels of miRNA-296-3p are higher in NVAF patients. These two indicators are correlated with disease progression, and their combined detection can provide more information for clinical diagnosis.更多还原