目的  探究维持性血液透析(maintenance hemodialysis，MHD)患者血清微小RNA(microRNA，miR)-222、miR-150表达与主要不良心血管事件(major adverse cardiovascular events，MACE)的关系。 方法  选取保定市第一医院2020年3月─2023年3月284例MHD患者，随访2年，按MACE发生情况分为MACE组(n=93)和非MACE组(n=191)。实时荧光定量聚合酶链反应(quantitative real-time polymerase chain reaction，qRT-PCR)检测血清miR-222、miR-150水平，Pearson相关性分析其与临床资料相关性，多元COX回归分析MACE影响因素，受试者工作特征(receiver operating characteristic，ROC)曲线分析预测价值。 结果  MACE组年龄、透析龄、肌钙蛋白、肌红蛋白均高于非MACE组(t=3.716、6.214、9.330、8.048，均P＜0.001)，血红蛋白、miR-222、miR-150低于非MACE组(t=7.097、9.833、9.257，均P＜0.001)。Pearson分析显示miR-222与年龄、透析龄、肌钙蛋白、肌红蛋白呈负相关(r=-0.432、-0.426、  -0.622、-0.593，均P＜0.001)，与血红蛋白(r=0.552，P＜0.001)呈正相关；miR-150与年龄、透析龄、肌钙蛋白、肌红蛋白呈负相关(r=-0.403、-0.384、-0.618、-0.581，均P＜0.001)，与血红蛋白呈正相关(r=0.522，P＜0.001)。多元COX回归显示年龄(HR=1.262，95%CI：1.048～1.520，P=0.014])、透析龄(HR=1.458，95%CI：1.099～1.933，P=0.009)、血红蛋白(HR=0.579，95%CI：0.373～0.898，P=0.015)、肌钙蛋白(HR=2.026，95%CI：1.266～3.243，P=0.003)、肌红蛋白(HR=2.522，95%CI：1.533～4.149，P＜0.001)、 miR-222(HR=0.446，95%CI：0.285～0.699，P=0.001)、miR-150(HR=0.536，95%CI：0.388～0.741，P＜0.001)是MACE发生的影响因素。ROC曲线显示联合预测MACE曲线下面积(area under the curve，AUC)为0.913(95%CI：0.880～0.945)，显著高于单独预测(miR-222：Z=2.482，P=0.013；miR-150：Z=3.109，P=0.002)。 结论  MHD患者血清miR-222、miR-150低表达与MACE发生风险增加相关，联合检测预测效能较高。

Objective  To investigate the relationship between serum microRNA (miR)-222 and miR-150 expression and major adverse cardiovascular events (MACE) in patients undergoing maintenance hemodialysis (MHD).  Methods  A total of 284 MHD patients admitted to the First Hospital of Baoding from March 2020 to March 2023 were enrolled and followed up for 2 years. Patients were divided into the MACE group (n=93) and non-MACE group (n=191) according to the occurrence of MACE. Serum miR-222 and miR-150 levels were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Pearson correlation analysis was used to examine the correlation with clinical data. Multivariate Cox regression analysis was performed to identify influencing factors of MACE. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the two microRNAs.  Results  Age, dialysis vintage, troponin, and myoglobin were higher in the MACE group than in the non‑MACE group (t=3.716, 6.214, 9.330, 8.048, all P<0.001), while hemoglobin, miR-222, and miR-150 were lower (t=7.097, 9.833, 9.257, all P<0.001). Pearson analysis showed that miR-222 was negatively correlated with age, dialysis vintage, troponin, and myoglobin (r=–0.432, –0.426, –0.622, –0.593, all P<0.001) and positively correlated with hemoglobin (r=0.552, P<0.001). miR-150 was negatively correlated with age, dialysis vintage, troponin, and myoglobin (r=–0.403,       –0.384, –0.618, –0.581, all P<0.001) and positively correlated with hemoglobin (r=0.522, P<0.001). Multivariate COX regression showed that age (HR=1.262, 95% CI: 1.048～1.520, P=0.014), dialysis vintage (HR=1.458, 95% CI: 1.099～1.933, P=0.009), hemoglobin (HR=0.579, 95% CI: 0.373～0.898, P=0.015), troponin (HR=2.026, 95% CI: 1.266～3.243, P=0.003), myoglobin (HR=2.522, 95% CI: 1.533～4.149, P<0.001), miR-222 (HR=0.446, 95% CI: 0.285～0.699, P=0.001), and miR-150 (HR=0.536, 95% CI: 0.388～0.741, P<0.001) were influencing factors for MACE. The ROC curve showed that the area under the curve (AUC) of combined detection for predicting MACE was 0.913 (95% CI: 0.880～0.945), which was significantly higher than that of each alone (miR-222: Z=2.482, P=0.013; miR-150: Z=3.109, P=0.002).  Conclusion  Low serum expression of miR-222 and miR-150 is associated with an increased risk of MACE in MHD patients, and the combined detection has high predictive efficacy.