Diagnostic value of cardiac troponin Ⅰ,N-terminal pro-brain natriuretic peptide and microRNA-146a in myocardial injury after multiple trauma
Objective To investigate the diagnostic value of cardiac troponin Ⅰ(cTn Ⅰ),plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)and microNRA(miR)-146a in patients with myocar-dial injury after multiple trauma.Methods From February 2021 to December 2023,91 patients with mul-tiple injuries admitte were selected as the research objects.According to whether the patients were compli-cated with myocardial injury,the 91 patients were divided into multiple trauma group(44 cases)and myo-cardial injury group(47 cases).The venous blood of the two groups was collected on admission and 3 days after injury.The expression levels of cTn Ⅰ and NT-proBNP were measured.The expression levels of miR-146a in serum was analyzed by fluorescence quantitative PCR.The expression levels of cTn Ⅰ,NT-proBNP and miR-146a at different time points were compared and analyzed between the two groups.The receiver operating characteristic curve was made to analyze the value of serum cTn Ⅰ,NT-proBNP and miR-146a in the diagnosis of myocardial injury after multiple trauma.Measurement data were compared by t test.Results The serum cTn Ⅰ level in the multiple trauma group on admission[(0.05±0.01)ng/ml]was significantly lower than that in the myocardial injury group[(1.46±0.44)ng/ml,t=20.260,P＜0.05].The serum troponin Ⅰ level in the multiple trauma group on admission 3 d[(0.06±0.02)ng/ml]was significantly lower than that in the myocardial injury group[(0.46±0.14)ng/ml,t=18.510,P＜0.05].The serum troponin Ⅰ level in the myocardial injury group on admission[(1.46±0.44)ng/ml]was significantly higher than that on admission 3 d[(0.46±0.14)ng/ml,t=14.940,P＜0.05].The serum N-terminal pro-brain natriuretic peptide level in the multiple trauma group on admission[(240.20± 20.37)pg/ml]was significantly lower than that in the myocardial injury group[(353.57±15.67)pg/ml,t=29.460,P＜0.05].The serum N-terminal pro-brain natriuretic peptide level in the multiple trauma group on admission 3 d[(254.83±20.92)pg/ml]was significantly lower than that in the myocardial inju-ry group[(302.04±18.67)pg/ml,t=11.190,P＜0.05].The serum NT-proBNP level in the myocardi-al injury group on admission[(353.57±15.67)pg/ml]was significantly higher than that on admission 3 d[(302.04±18.67)pg/ml,t=14.940,P＜0.05].The serum miR-146a level in the multiple trauma group on admission(1.55±0.13)was significantly higher than that in the myocardial injury group(0.79±0.17,t=23.050,P＜0.05).The serum miR-146a level in the multiple trauma group on admis-sion 3 d(1.49±0.15)was significantly higher than that in the multiple trauma group on admission(1.36±0.12,t=18.550,P＜0.05).The sensitivity,specificity and accuracy of the combined detection of three indicators in the diagnosis of multiple trauma with myocardial injury were 89.65％,87.49％and 84.67％,respectively.Conclusion The levels of serum troponin Ⅰ and plasma NT-proBNP were signifi-cantly increased in patients with myocardial injury,while the expression level of miR-146a was significantly decreased.The combined detection of the three indicators has important value in the diagnosis of myocardi-al injury after multiple trauma.
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