血浆miR-499对急性心肌梗死的诊断价值  

Diagnostic performance of plasma miR-499 for acute myocardial infarction

作　　者：韩志君[1] 史万青[2] 沈红远[1] 黄红宇[1] 马宁[1] 李玉生[1] 严子禾[1] 

机构地区：[1]无锡市第二人民医院检验科,214002 [2]滁州市第一人民医院心血管内科

出　　处：《中华检验医学杂志》2013年第12期1096-1099,共4页Chinese Journal of Laboratory Medicine

基　　金：无锡市医院管理中心医学科技发展基金资助项目（YGM1119）

摘　　要：目的评价miR499对急性心肌梗死（AMI）的诊断价值。方法诊断准确性试验。收集2010年11月至2011年7月无锡市第二人民医院、滁州市第一人民医院AMI患者131例（46例ST段抬高的心肌梗死患者和85例非sT段抬高的心肌梗死患者）以及78例非AMI患者，同时选取60名健康体检者作为对照。收集胸痛疑似AMI患者就诊2h内的血浆。荧光定量PCR法检测血浆中miR499的相对丰度，以受试者工作特征曲线（ROC）分析血浆miR499对AMI的诊断价值，多参数logistic回归模型分析血浆miR-499与AMI的关系。结果AMI患者血浆miR499的循环阈值差值（ACT）为1．01±3．34，非AMI的胸痛患者miR499的ACT为-2．76±2．90，健康对照组的ACT为-3．79±2．21，差异有统计学意义（X2=96．77，P〈0．01）。血浆miR-499诊断AMI的曲线下面积（AUC）为0．80（95％可信区间：0．74～0．86），较就诊时的肌钙蛋白I（cTnI）（AUC=0．90，95％可信区间：0．86～0．94）偏低（P〈0．01）。当血浆miR499取值为0．18时，其诊断AMI的敏感度（95％可信区间）和特异度（95％可信区间）分别为0．69（0．61～0．77）和0．77（0．66～0．86）。血浆miR499与cTnI的相关系数为0．72（P〈0．01）。在校正了cTnI以后，血浆miR-499相对丰度〉0．18，仍然与AMI相关，其优势比（95％可信区间）为2．59（1．10—6．07）。结论血浆miR499是诊断AMI的有益标志物，可以提供cTnI以外的诊断信息，二者联合应用可能有助于提高AMI的诊断准确性。Objective To evaluate the diagnostic performance of plasma miR-499 in acute myocardial infarction （AMI） diagnosis. Methods Diagnostic accuracy test. The suspected AMI patients, who with chest pain for more than half an hour and been admitted in the Second People＇s Hospital of Wuxi and First People＇s Hospital of chuzhou during October 2010 and July 2011, were consecutively and prospectively enrolled in the present study. Sixty apparently healthy individuals were designed as healthy control. The plasma samples of the suspected AMI patients were collected within two hours after admission. The plasma miR-499 was determined by real time polymerase chain reaction （ RT-PCR ）. The diagnostic performance of plasma miR-499 for AMI was estimated by receiver operating characteristic （ ROC ） curve analysis. The association between plasma miR-499 and AMI was analyzed by multivariable logistic model. The plasma miR-499 was determined and explained in blind fashion. Results Two hundred and nine suspected AMI patients, including 131 confirmed AMI patients （46 STEMI and 85 NSTEMI） and 78 AMI free patients were enrolled in the present study. The delta cycle threshold （ACT） was 1.01 ＋3.34 for AMI patients, -2. 76 -＋ 2. 90 for non-AMI patients and -3.79 -＋ 2. 21 for healthy controls. The differences had statistical significance （ X2 = 96. 77, P 〈 0. 01 ）. The area under curve （AUC） of plasma miR-499 was 0. 80 （95% CI： O. 74- 0. 86）, lower than that of cardiac troponin I （AUC = 0. 90, 95% CI： O. 86 -0.94） on admission （ P 〈 0. 01 ）. At the optimal cut-off of 0. 18, the diagnostic sensitivity and specificity were 0. 69 （95 % CI： 0. 61 - 0. 77 ） and 0.77 （ 95% CI： 0. 66 - 0. 86 ） , respectively. The coefficient of correlation between plasma miR-499 and eTn] was 0. 72 （ P 〈 0. 01 ）. The odds ratio （OR） of plasma miR-499 〉 0. 18for AMI was 2. 59 （95% CI： 1.10 -6. 07）, after adjusted cTnI. Conclusions Plasma miR-499 is a useful biomarker for AMI diagnos

关 键 词：心肌梗死 微RNAS 生物学标记 敏感性与特异性 

分 类 号：R542.22[医药卫生—心血管疾病]