[1]刘晓霞 吴宝全.外周血miR-26a-5p水平变化与高血压性左心室肥厚的关系分析[J].心血管病学进展,2020,(5):556-562.[doi:10.16806/j.cnki.issn.1004-3934.2020.05.027]
　LIU Xiaoxia,WU Baoquan.Relationship Between Changes of Peripheral Blood miR-26a-5p Levels and Hypertensive Left Ventricular Hypertrophy[J].Advances in Cardiovascular Diseases,2020,(5):556-562.[doi:10.16806/j.cnki.issn.1004-3934.2020.05.027]
点击复制

外周血miR-26a-5p水平变化与高血压性左心室肥厚的关系分析()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年5期
页码:
556-562
栏目:
出版日期:
2020-05-25

文章信息/Info

Title:
Relationship Between Changes of Peripheral Blood miR-26a-5p Levels and Hypertensive Left Ventricular Hypertrophy
作者:
刘晓霞1 吴宝全2
(1.张家口市第一医院老年病科,河北 张家口 075000;2.张家口市第一医院心内科,河北 张家口 075000)
Author(s):
LIU Xiaoxia;  WU Baoquan
(1. Department of Geriatrics, 2. Cardiology Department, The First Hospital of Zhangjiakou City, Zhangjiakou 075000, Hebei, China)?/html>
关键词:
高血压; 左心室肥厚; 微小RNA-26a-5p; 诊断; 血管重塑
Keywords:
Hypertension;  Left ventricular hypertrophy;  MicroRNA-26a-5p;  Diagnosis;  Vascular remodeling
DOI:
10.16806/j.cnki.issn.1004-3934.2020.05.027
摘要:
目的 分析外周血miR-26a-5p水平与高血压性左心室肥厚的关系。方法 招募符合条件的高血压 患者98例，其中单纯高血压患者66例（高血压组），高血压伴左心室肥厚患者32例（左心室肥厚组），并选正常健康志愿者30例作为对照组，比较各组收缩压和舒张压差别；并采集空腹静脉血，实时荧光定量逆转录聚合酶联反应法（qRT-PCR）测定外周血miR-26a-5p水平，按左心室肥厚程度分组，比较不同左心室肥厚程度患者外周血miR-26a-5p水平的差异；超声心动图测定舒张期左心室后壁厚度（LVPWTd）、室间隔舒张末期厚度（LVsd）和舒张末期左心室内径（LVEDD），计算左心室质量（LVM）及左心室质量指数（LVMI），比较高血压组与左心室肥厚组以上各参数的差异，单因素和多因素分析筛选高血压患者发生左心室肥厚的危险因素，受试者工作特征曲线评估miR-26a-5p诊断高血压性左心室肥厚的效能，Pearson相关分析法分析高血压性左心室肥厚miR-26a-5p与超声心动图参数的关系。结果 血miR-26a-5p比较：左心室肥厚组（0.365±0.097）、高血压组（0.725±0.163）外周血miR-26a-5p低于对照组（0.973±0.105），左心室肥厚组又低于高血压组，P<0.05，高血压伴重度左心室肥厚患者外周血miR-26a-5p（0.276±0.065）水平＞中度组（0.357±0.095）＞轻度组（0.463±0.112），P<0.05；收缩压比较：左心室肥厚组[（171.15±27.96）mm Hg]＞高血压组[（142.63±16.52）mm Hg]＞对照组[（1 115.23±7.43）mm Hg](115.23±7.43)???，P<0.05；超声心动图参数比较：左心室肥厚组LVPWTd、LVsd、LVEDD、LVMI[（11.05±0.89）mm、（11.76±1.23）mm、（48.63±3.79）mm、（53.67±5.98）g/m2.7]高于高血压组[（9.95±1.02）mm、（10.46±1.63）mm、（44.23±4.07）mm、（37.71±6.52）g/m2.7]与对照组[（9.76±1.21）mm、（10.32±1.74）mm、（43.78±5.17）mm、（36.51±5.75）g/m2.7]，P<0.05；年龄（OR=1.420）、高血压病程（OR=1.706）、血尿酸（OR=1.306）及miR-26a-5p（OR=1.502）均为高血压患者出现左心室肥厚的相关影响因素，P<0.05；诊断效能：miR-26a-5p cut-off值≤0.428，预测高血压性左心室肥厚敏感性和特异性分别为81.25%和87.88%；相关性：高血压性左心室肥厚miR-26a-5p与LVPWtd、LVsd、LVEDD、LVMI均呈负相关（r=－0.391、－0.375、－0.574、－0.403，P<0.05）。结论 高血压性左心室肥厚伴外周血miR-26a-5p异常低表达，且与左心室肥厚参数呈负相关，推测miR-26a-5p或可能通过负调控机制参与高血压心肌肥厚进展过程。
Abstract:
Objective To analyze the relationship between peripheral blood miR-26a-5p level and hypertensive left ventricular hypertrophy. Methods 98 eligible patients with hypertension were recruited, including 66 with simple hypertension (hypertension group) and 32 with hypertensive left ventricular hypertrophy (left ventricular hypertrophy group), and 30 normal healthy volunteers were selected as the control group. The systolic blood pressure and diastolic blood pressure were compared among groups. Fasting venous blood of all subjects was collected to determine the peripheral blood miR-26a-5p level by real-time fluorescent quantitative reverse transcription polymerase chain reaction (qRT-PCR). According to the degree of left ventricular hypertrophy, the patients were grouped, and peripheral blood miR-26a-5p levels in patients with different degrees of left ventricular hypertrophy were compared. The left ventricular end diastolic posterior wall thickness (LVPWTd) , ventricular septal end diastolic thickness (LVsd) and left ventricular end diastolic diameter (LVEDD) were measured with echocardiography. The left ventricular mass (LVM) and left ventricular mass index (LVMI) were calculated. T he above parameters in hypertension group and left ventricular hypertrophy group were compared . Risk factors for left ventricular hypertrophy in patients with hypertension were screened through univariate and multivariate analyses. The efficiency of miR-26a-5p in diagnosing hypertensive left ventricular hypertrophy was evaluated with the receiver operating characteristic (ROC) curve. Pearson correlation analysis was conducted to analyze the relationship between hypertensive left ventricular hypertrophy miR-26a-5p and echocardiographic parameters. Results The order of blood miR-26a-5p from low to high was as follows: left ventricular hypertrophy group (0.365±0.097), hypertension group (0.725±0.163), control group (0.973± 0.105) (P<0.05). The order of peripheral blood miR-26a-5p level in patients with hypertension and different degrees of left ventricular hypertrophy from high to low was as follows: severe group (0.276±0.065), m oderate group (0.357±0.095), mild group (0.463±0.112) (P<0.05). The order of systolic blood pressure from high to low was as follows: left ventricular hypertrophy group [(171.15±27.96) mmHg], hypertension group [(142.63±16.52) mmHg], control group [(1115.23±7.43) mmHg] (P<0.05). LVPWTd, LVsd, LVEDD and LVMI in the left ventricular hypertrophy group [( 11.05±0.89) mm, (11.76±1.23) mm, (48.63±3.79) mm, (53.67±5.98) g/m2.7] were larger than those in hypertension group [(9.95±1.02) mm, (10.46±1.63) mm, (44.23±4.07) mm, (37.71±6.52) g/m2.7] or control group [( 9.76±1.21) mm, (10.32±1.74) mm, (43.78±5.17) mm, (36..51±5.75) g/m2.7] ( P<0.05). Age ( OR=1.420), duration of hypertension ( OR=1.706), blood uric acid (OR=1.306) and miR-26a-5p (OR=1.502) were risk factors for left ventricular hypertrophy in patients with hypertension (P<0.05). When the cut-off value of miR-26a-5p was not larger than 0.428, the sensitivity and specificity in predicting hypertensive left ventricular hypertrophy were 81.5% and 87.88%, respectively. H ypertensive left ventricular hypertrophy miR-26a-5p was negatively correlated with LVPWtd, LVsd, LVEDD and LVMI (r=﹣0.391, ﹣0.375, ﹣0.574, ﹣0.403, P<0.05). Conclusion Hypertensive left ventricular hypertrophy is complicated with abnormally low expression of miR-26a-5p in peripheral blood and it is negatively correlat ed with left ventricular hypertrophy parameters. It is speculated that miR-26a-5p may participate in the progression of hypertensive myocardial hypertrophy through a negative regulation mechanism.

参考文献/References:

[1].林德洪,钟江华,郑颖,等.miRNA-1在高血压左心室肥厚诊断中的价值[J].临床心血管病杂志,2017,33(10):962-965.
[2].Hamdani G,Nehus EJ,Hanevold CD,et al. Ambulatory blood pressure,left ventricular hypertrophy,and allograft function in children and young adults after kidney transplantation[J]. Transplantation,2017,101(1):150-156.
[3].蒋显超.肥厚型心肌病的基因治疗研究进展[J].心血管病学进展,2018,39(3):335-339.
[4].Liga R,Gimelli A,Marzullo P,et al. Myocardial 123I-metaiodobenzylguanidine imaging in hypertension and left ventricular hypertrophy[J]. J Nucl Cardiol,2018,25(2):461-470.
[5].张娟妞,张国春,冯红旗,等.循环微小RNA-133a、半乳糖凝集素-3在慢型克山病与扩张型心肌病中的差异表达及临床应用价值[J].中华地方病学杂志,2018,37(5):362-365.
[6].张楚婕.循环微小RNA诊断心肌病变的研究进展[J].复旦学报(医学版),2017,44(1):110-116.
[7].Niemirska A,Litwin M,Trojanek J,et al. Altered matrix metalloproteinase 9 and tissue inhibitor of metalloproteinases 1 levels in children with primary hypertension[J]. J Hypertens,2016, 34(9):1815-1822.
[8].Duman H,Bah?eci I,?inier G,et al. Left ventricular hypertrophy is associated with increased sirtuin level in newly diagnosed hypertensive patients[J].Clin Exp Hypertens,2019,41(6):511-515.
[9].Bursztyn M,Jacobs JM,Hammerman-Rozenberg A,et al. Prevalence of orthostatic hypertension in the very elderly and its relationship to all-cause mortality[J]. J Hypertens,2016, 34(10):2053-2058.
[10].中国成人血脂异常防治指南修订联合委员会. 中国成人血脂异常防治指南（2016年修订版）[J]. 中华心血管病杂志,2016,31(10):833-853.
[11].Tsuruda T,Sekita-Hatakeyama Y,Hao Y,et al. Angiotensin Ⅱ stimulation of cardiac hypertrophy and functional decompensation in osteoprotegerin-deficient mice[J]. Hypertension, 2016,67(5):848-856.
[12].高明喜,廖敏蕾,温沁竹.循环miRNA-29a-3P水平变化与高血压患者左室肥厚的关系分析[J].临床和实验医学杂志,2018,17(9):925-928.
[13].No authors listed. Correction to:miR-143 activation regulates smooth muscle and endothelial cell crosstalk in pulmonary arterial hypertension[J]. Circ Res,2017,120(4):e6.
[14].Wachtell K,Okin PM. An age-old test in old age:ECG left ventricular hypertrophy and cardiovascular outcomes in the elderly[J]. J Hypertens,2016,34(11):2145-2146.
[15].Saleh L,Samantar R,Garrelds IM,et al. Low soluble Fms-like tyrosine kinase-1,endoglin, and endothelin-1 levels in women with confirmed or suspected preeclampsia using proton pump inhibitors[J]. Hypertension,2017,70(3):594-600.
[16].Chen Y,Liu JH,Zhen Z,et al. Assessment of left ventricular function and peripheral vascular arterial stiffness in patients with dipper and non-dipper hypertension[J]. J Investig Med,2018, 66(2):319-324.
[17].Moazzami K,Ostovaneh MR,Ambale Venkatesh B,et al. Left ventricular hypertrophy and remodeling and risk of cognitive impairment and dementia:MESA (Multi-Ethnic Study of Atherosclerosis)[J]. Hypertension,2018,71(3):429-436.

相似文献/References:

[1]孙刚,黄冠华,综述.高血压合并心力衰竭的治疗策略[J].心血管病学进展,2016,(2):201.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.027]
　SUN Gang,HUANG Guanhua.Treatment Strategy of Hypertension with Heart Failure[J].Advances in Cardiovascular Diseases,2016,(5):201.[doi:10.16806/j.cnki.issn.1004-3934.2016.02.027]
[2]范贵娟,综述,徐瑞,等.盐敏感性高血压的研究进展[J].心血管病学进展,2016,(4):364.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.010]
　FAN Guijuan,XU Rui.Research Progress of Salt Sensitive Hypertension[J].Advances in Cardiovascular Diseases,2016,(5):364.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.010]
[3]陈源源.钙通道阻滞剂在降压治疗中的应用[J].心血管病学进展,2015,(6):662.[doi:10.3969/j.issn.1004-3934.2015.06.002]
　CHEN Yuanyuan.Application of Calcium Channel Blockers in Hypertension Treatment[J].Advances in Cardiovascular Diseases,2015,(5):662.[doi:10.3969/j.issn.1004-3934.2015.06.002]
[4]张瑞 毛露 孙硕 Dirk Hermann 陈艾东.内皮素-1干预成为高血压治疗新靶点的展望[J].心血管病学进展,2019,(7):969.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.000]
　ZHANG Rui MAO LuSUN ShuoDIRK Hermann CHEN Aidong.The Prospect of Endothelin-1 Intervention as A New Target for the Treatment of Hypertension[J].Advances in Cardiovascular Diseases,2019,(5):969.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.000]
[5]张毅,柳志红.动态血压监测在高血压中的应用现状与问题[J].心血管病学进展,2019,(6):848.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.003]
　ZHANG Yi,LIU Zhihong.Current status and nsolved Pproblems of Ambulatory Blood Pressure Monitoring for the Management of Hypertension[J].Advances in Cardiovascular Diseases,2019,(5):848.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.003]
[6]黄秋瑾 胡蓉.高血压合并糖尿病患者血压控制率和控制目标的探讨[J].心血管病学进展,2019,(7):973.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.002]
　HUANG QiujinHU Rong.Discussion on Blood Pressure Control Rate and Control Target in Patients with Hypertension Complicated with Diabetes[J].Advances in Cardiovascular Diseases,2019,(5):973.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.002]
[7]张旭明 王曦.高血压对认知功能的影响[J].心血管病学进展,2019,(7):977.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.003]
　ZHANG Xuming,WANG Xi.The Relationship Between Hypertension and Cognitive Function[J].Advances in Cardiovascular Diseases,2019,(5):977.[doi:10.16806/j.cnki.issn.1004-3934.2019.07.003]
[8]凌梦军 陈明凌梦军.阻塞性睡眠呼吸暂停低通气综合征与高血压关系的研究进展[J].心血管病学进展,2019,(5):722.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.015]
[9]李波 郭毅 田进文 邓珏琳.高血压合并2型糖尿病的治疗进展[J].心血管病学进展,2019,(9):1196.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.002]
　LI Bo,GUO Yi,TIAN Jinwen,et al.Therapy in Hypertensive Patients with Type 2 Diabetes Mellitus[J].Advances in Cardiovascular Diseases,2019,(5):1196.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.002]
[10]王继航 赵施皓 李开亮 田进文 李玉龙 付士辉 沈明志 邓珏琳.远程医疗在高血压病管理中的研究进展[J].心血管病学进展,2019,(9):1199.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.003]
　WANG Jihang,ZHAO Shihao,LI Kailiang,et al.Telemedicine in Hypertension Management[J].Advances in Cardiovascular Diseases,2019,(5):1199.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.003]

备注/Memo

备注/Memo:
基金项目：河北省科研厅卫生项目（1821094D）
更新日期/Last Update: 2020-08-12