摘要
目的 探讨血清微小RNA-125b-5p(miR-125b-5p)和微小RNA-509-5p(miR-509-5p)在急性心肌梗死(AMI)患者血清中的表达及意义.方法 选取2020年4月至2023年4月于郑州大学附属郑州市中心医院高血压科收治的126例AMI患者为研究对象(AMI组),根据Killip分级将AMI患者分为Killip Ⅰ级组(n=47)、Killip Ⅱ级组(n=44)和Killip Ⅲ级组(n=35),另选取同期我院健康体检的志愿者126例作为对照组.比较各组血清miR-125b-5p、miR-509-5p水平及心肌损伤相关指标如肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)、脑钠肽(BNP)水平;Pearson法分析急性心肌梗死患者血清miR-125b-5p、miR-509-5p与心肌损伤相关指标的相关性;Logistic回归分析影响急性心肌梗死发生的因素;ROC曲线分析血清miR-125b-5p、miR-509-5p对急性心肌梗死的诊断价值.结果 急性心肌梗死组患者血清miR-509-5p、CK-MB、cTnⅠ、BNP水平均显著高于对照组(P＜0.05),血清miR-125b-5p、左室射血分数(LVEF)水平显著低于对照组(P＜0.05);患者血清miR-125b-5p水平与CK-MB、cTnⅠ、BNP水平呈负相关,与LVEF呈正相关(P＜0.05),血清miR-509-5p水平与CK-MB、cTnⅠ、BNP水平呈正相关,与LVEF呈负相关(P＜0.05).随着Killip分级增加,血清miR-125b-5p呈逐渐递减趋势,血清miR-509-5p呈逐渐递增趋势,三组两两比较差异均有统计学意义(P＜0.05).Logistic回归分析显示,miR-509-5p、CK-MB、cTnⅠ、BNP是影响AMI发生的危险因素,miR-125b-5p、LVEF是保护因素(P＜0.05);血清miR-125b-5p、miR-509-5p两者联合诊断急性心肌梗死的敏感度为94.29％,特异性为87.91％,联合诊断效能优于各自单独诊断(Z二者联合-miR-125b-5p=2.531、Z二者联合-miR-509-5p=2.243,P=0.011、P=0.025).结论 AMI患者血清miR-125b-5p水平下降,miR-509-5p水平上升,与心肌损伤相关指标水平及病情严重程度有关,二者联合对AMI具有较高诊断价值.
Abstract
Objective To investigate the expression and significance of serum microRNA-125b-5p(miR-125b-5p)and microRNA-509-5p(miR-509-5p)in patients with acute myocardial infarction(AMI).Methods A total of 126 AMI patients admitted to Department of Hypertension,Zhengzhou Central Hospital Affiliated to Zhengzhou University from April 2020 to April 2023 were regarded as the study subjects(AMI group),AMI patients were separated into Killip grade Ⅰ group(n=47),Killip grade Ⅱ group(n=44),and Killip grade Ⅲ group(n=35)based on Killip grading,another 126 volunteers who underwent physical examinations in our hospital were collected as the control group;the levels of serum miR-125b-5p,miR-509-5p,and myocardial injury related indicators[Creatine kinase isoenzyme(CK-MB),cardiac troponin Ⅰ(cTnⅠ),brain natriuretic peptide(BNP)]in each group were compared;Pearson method was applied to analyze the correlation between serum miR-125b-5p,miR-509-5p and myocardial injury related indicators in AMI patients;Logistic regression was applied to analyze the factors that affected the occurrence of AMI;receiver operating characteristic was applied to analyze the diagnostic value of serum miR-125b-5p and miR-509-5p for AMI.Results The serum levels of miR-509-5p,CK-MB,cTnⅠ,and BNP in the AMI group were obviously higher than those in the control group(P＜0.05),while the serum levels of miR-125b-5p and Left ventricular ejection fraction(LVEF)were obviously lower than those in the control group(P＜0.05);the serum miR-125b-5p level in AMI patients was negatively correlated with CK-MB,cTnⅠ,BNP levels,and positively correlated with LVEF(P＜0.05),the serum miR-509-5p level was positively correlated with CK-MB,cTnⅠ,BNP levels,and negatively correlated with LVEF(P＜0.05);as Killip grading increased,serum miR-125b-5p showed a gradually decreasing trend,while serum miR-509-5p showed a gradually increasing trend,the differences between the any two of the three groups were statistically obvious(P＜0.05);Logistic regression analysis showed that miR-509-5p,CK-MB,cTnⅠ,BNP were risk factors that affected the occurrence of AMI,while miR-125b-5p and LVEF were protective factors(P＜0.05);the sensitivity and specificity of the combination of serum miR-125b-5p and miR-509-5p in the diagnosis of AMI was 94.29％and 87.91％,respectively,the combined diagnostic efficacy was superior to their respective individual diagnoses(Zcombination-miR-125b-5p=2.531,Zcombination-miR-509-5p=2.243,P=0.011,P=0.025).Conclusion The serum miR-125b-5p level in AMI patients decreases,while miR-509-5p level increases,which is related to the levels of myocardial injury related indicators and the severity of the condition.The combination of the two has high diagnostic value for AMI.
基金项目
河南省医学科技攻关计划联合共建项目(LHGJ20210383)
维普
万方数据