目的:分析成人重症病毒性心肌炎患者血清微小RNA-155(miR-155)、微小RNA-146b(miR-146b)表达与恶性心律失常的关系。方法:抽取2019年1月至2020年3月驻马店市中心医院收治的76例成人重症病毒性心肌炎患者作为研究对象。记录患者恶性心律失常发生情况，并根据有无发生恶性心律失常分为发生组和未发生组，比较两组入院当天血清miR-155、miR-146b表达情况及其与患者恶性心律失常发生的关系。结果:76例成人重症病毒性心肌炎患者中28例(36.84%)发生恶性心律失常；发生组与未发生组患者年龄、家庭条件、家庭月收入等基线资料比较，差异未见统计学意义(n P>0.05)；发生组血清miR-155、miR-146b表达均高于未发生组，差异有统计学意义(n P1，n P0.85，有一定预测价值。n 结论:成人重症病毒性心肌炎患者发生恶性心律失常风险高，这种恶性心律失常高风险可能与患者血清miR-155、miR-146b异常过表达有关。“,”Objective:To analyze the relationship between the expression of serum microRNA-155 (miR-155) and microRNA-146b(miR-146b) and malignant arrhythmia in adults with severe viral myocarditis, and to guide the early evaluation and intervention of malignant arrhythmia in adults with severe viral myocarditis in the future.Methods:A total of 76 adult patients with severe viral myocarditis treated in Zhumadian Center Hospital from January 2019 to March 2020 were selected as the research objects. The occurrence of malignant arrhythmia in patients were recorded, and they were divided them into occurrence group and non-occurrence group according to the occurrence of malignant arrhythmia, and the serum miR-155 and miR-146b expressions on the day of admission between the two groups and their relationship with the occurrence of malignant arrhythmias were compared.Results:Of the 76 adult patients with severe viral myocarditis, 28 cases occurred malignant arrhythmia, the incidence rate was 36.84%; the baseline data such as age, family conditions, and monthly family income between the occurrence group and the non-occurrence group were compared, the difference was not statistically significant (n P>0.05); the expression of serum miR-155 and miR-146b in the occurrence group were higher than those in the non-incidence group (n P1,n P 0.85, which had certain predictive value.n Conclusions:Adult patients with severe viral myocarditis have a high risk of developing malignant arrhythmia. This high risk of malignant arrhythmia may be related to the abnormal overexpression of miR-155 and miR-146b in serum. In the future, the two can be considered as the main indicators for predicting the risk of malignant arrhythmia in adults with severe viral myocarditis, which may have positive significance for early risk assessment, intervention and improvement of patient’s prognosis.