血浆微小核糖核酸-1和微小核糖核酸-146b表达水平与急性ST段抬高型心肌梗死诊断及预后的相关性研究

发布时间：2018-04-10 13:17

本文选题：心肌梗死 + 微小RNAs　；参考：《中国循环杂志》2017年11期

【摘要】：目的:观察早期急性ST段抬高型心肌梗死(STEMI)患者血浆微小核糖核酸(mi R)-1和mi R-146b表达水平的变化,探讨其对急性STEMI的早期诊断价值和与患者预后的相关性。方法:选取急性STEMI患者47例和健康对照受试者23例,在患者入院即刻、发病12(hT12)、24(hT24)、48(hT48)、72 h(T72)、1周(T1W)收集血液标本并用实时定量聚合酶链式反应检测血浆mi R-1和mi R-146b表达水平,同时收集患者对应时间点血浆心肌肌钙蛋白(c Tn T)水平,并与对照受试者进行对比。用受试者工作特征(ROC)曲线评估患者入院即刻血浆mi R-1、mi R-146b表达水平对急性STEMI的诊断价值;评估入院即刻血浆mi R-1、mi R-146b表达水平与C反应蛋白、B型利钠肽、白细胞计数的相关性;随访患者确诊1个月内主要不良心血管事件发生情况;分析峰值时间血浆mi RNA-1、mi R-146b不同表达水平患者的30天累积生存率。结果:急性STEMI患者入院即刻、T12、T24、T48血浆中mi R-1、mi R-146b的表达水平以及入院即刻、T12、T24、T48、T72外周血中c Tn T表达水平较对照受试者均升高,差异均有统计学意义(P均0.05);入院即刻血浆mi R-1、mi R-146b表达水平对于诊断急性STEMI的ROC曲线下面积分别为0.800、0.789(P均0.001);入院即刻血浆mi R-146b表达水平与C反应蛋白、B型利钠肽、白细胞计数呈正相关关系(P均0.05);峰值时间血浆mi R-1、mi R-146b高表达患者的30天累积生存率明显低于低表达患者(P均0.05)。结论:血浆mi R-1和mi R-146b有可能作为早期诊断急性STEMI的生物标志物,血浆mi R-1和mi R-146b表达水平的高低与急性STEMI患者预后存在相关性。
[Abstract]:Objective: to observe the changes of plasma minute ribonucleic acid mira-1 and miR-146b expressions in patients with early acute ST-segment elevation myocardial infarction (STEMI), and to explore the value of early diagnosis of acute STEMI and its correlation with the prognosis of the patients.Methods: blood samples were collected from 47 patients with acute STEMI and 23 healthy controls. Blood samples were collected and the expression levels of mi R-1 and mi R-146b in plasma were detected by real-time quantitative polymerase chain reaction (RPCR).At the same time, the plasma levels of cardiac troponin C Tn T were collected and compared with those of the control subjects.The diagnostic value of plasma mi R-1n mi R-146b expression in patients with acute STEMI was evaluated by using the operating characteristics of the subjects at admission, and the correlation between the expression level of plasma mi R-1n mi R-146b and C-reactive protein B type natriuretic peptide and white blood cell count was evaluated.The incidence of major adverse cardiovascular events within one month was confirmed and the 30-day cumulative survival rate of patients with different expression levels of plasma mi RNA-1 and mi R-146b at peak time was analyzed.Results: the expression of miR-1nT in plasma of patients with acute STEMI and the expression of c TnT in peripheral blood of patients with acute STEMI were higher than those of control subjects.The difference was statistically significant (P < 0.05), the area under the ROC curve of the diagnosis of acute STEMI was 0.800 卤0.789 (P = 0.001), and the expression level of plasma mi R-146b and C-reactive protein B type natriuretic peptide were 0.800 卤0.789 ~ (-1) P, respectively, at admission, the expression level of miR-146b in plasma and C-reactive protein B type natriuretic peptide were measured.The 30 day cumulative survival rate of patients with high expression of miR-1n / mi R-146b was significantly lower than that of patients with low expression (P < 0.05).Conclusion: plasma miR-1 and miR-146b may be used as biomarkers for early diagnosis of acute STEMI, and the levels of plasma miR-1 and miR-146b are correlated with the prognosis of patients with acute STEMI.
【作者单位】：徐州医科大学附属医院心内科;
【基金】：徐州科技局项目(KC15SX003)
【分类号】：R542.22

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