[摘要] 目的 分析血清miR-181b、长链非编码RNA（long noncoding RNA，lncRNA）心肌梗死相关转录本（myocardial infarction association transcript，MIAT）对高血压肾病的诊断价值。方法 选取2022年10月至2024年10月金华市人民医院收治的原发性高血压患者120例为研究对象，根据尿白蛋白与肌酐比值将其分为高血压肾病组（68例）和单纯高血压组（52例），另选取同期60例健康体检者为对照组。比较各组血清miR-181b、lncRNA MIAT、超敏C反应蛋白（hypersensitive C-reaction protein，hs-CRP）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素（interleukin，IL）-6。结果 三组受试者的hs-CRP、TNF-α、IL-6、miR-181b、lncRNA MIAT比较差异均有统计学意义（Plt;0.05），其中hs-CRP、TNF-α、IL-6、lncRNA MIAT水平高血压肾病组gt;单纯高血压组gt;对照组，miR-181b水平高血压肾病组lt;单纯高血压组lt;对照组。Pearson相关分析结果显示高血压肾病患者的血清miR-181b表达与lncRNA MIAT、hs-CRP、TNF-α、IL-6水平呈负相关（Plt;0.05），而lncRNA MIAT表达与hs-CRP、TNF-α、IL-6水平呈正相关（Plt;0.05）。受试者操作特征曲线评估miR-181b、lncRNA MIAT诊断高血压肾病的敏感度分别为97.1%、73.5%，特异性分别为68.7%、92.1%，曲线下面积分别为0.819、0.951。结论 miR-181b、lncRNA MIAT在高血压肾病患者血清中异常表达，有望成为高血压肾病早期诊断的潜在标志物。

[关键词] 原发性高血压；高血压肾病；miR-181b；lncRNA MIAT

[中图分类号] R544.14" """"[文献标识码] A """""[DOI] 10.3969/j.issn.1673-9701.2025.19.007

The diagnostic value of serum miR-181b and lncRNA MIAT in hypertensive nephropathy

CHEN Yun¹， LI Chao²

1.Department of Nephrology， Jinhua People’s Hospital， Jinhua 321002， Zhejiang， China; 2.Department of Cardiovascular Medicine， Jinhua People’s Hospital， Jinhua 321002， Zhejiang， China

[Abstract] Objective To analyze the diagnostic value of serum miR-181b and long noncoding RNA （lncRNA） myocardial infarction association transcript （MIAT） for hypertensive nephropathy. Methods A total of 120 patients with essential hypertension admitted to Jinhua People’s Hospital from October 2022 to October 2024 were selected as research subjects. According to urinealbumin-to-creatinine ratio， they were divided into hypertensive nephropathy group （68 cases） and simple hypertension group （52 cases）， and another 60 healthy individuals undergoing physical examinations during the same period were selected as control group. The serum miR-181b， lncRNA MIAT， hypersensitive C-reaction protein （hs-CRP）， tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in each group were compared. Results There were statistically significant differences in hs-CRP， TNF-α， IL-6， miR-181b and lncRNA MIAT among three groups （Plt;0.05）. Among them， the levels of hs-CRP， TNF-α， IL-6 and lncRNA MIAT in hypertensive nephropathy group gt; simple hypertension group gt; control group， and miR-181b level was in hypertensive nephropathy group lt; simple hypertension group lt; control group. The results of Pearson correlation analysis showed that expression of serum miR-181b in patients with hypertensive nephropathy was negatively correlated with the levels of lncRNA MIAT， hs-CRP， TNF-α， and IL-6 （Plt;0.05）， while expression of lncRNA MIAT was positively correlated with the levels of hs-CRP， TNF-α， and IL-6 （Plt;0.05）. The sensitivity of miR-181b and lncRNA MIAT in the diagnosis of hypertensive nephropathy evaluated by receiver operating characteristic curve was 97.1% and 73.5% respectively， the specificity was 68.7% and 92.1% respectively， and area under the curve were 0.819 and 0.951 respectively. Conclusion miR-181b and lncRNA MIAT are abnormally expressed in the serum of patients with hypertensive nephropathy and are expected to become potential markers for early diagnosis of hypertensive nephropathy.

[Key words] Essential hypertension; Hypertensive nephropathy; MiR-181b; LncRNA MIAT

高血压肾病是原发性高血压（essential hypertension，EH）的并发症之一，因肾小动脉硬化可引起夜尿增多、轻–中度蛋白尿及不同程度的肾功能损害^[1]。中国肾脏疾病网络2016年数据证实，高血压肾病居慢性肾脏病住院患者病因的第二位，且有高血压肾损害的慢性肾脏病患者并发心血管疾病的风险更高^[2]。因此，寻找一种简单、易行的血清指标对高血压肾病进行早期诊断和预后评估具有重大临床价值。研究证实微RNA（microRNA，miRNA）、长链非编码RNA（long noncoding RNA，lncRNA）参与EH的发生发展过程^[3-4]。miR–181b可下调组织金属蛋白酶抑制剂-3、转化生长因子-β等细胞因子的表达，抑制炎症反应，负向调节EH的发生发展^[5]。……