microRNA-1对急性心肌梗死的早期诊断价值研究  

Value of microRNA-1 in early diagnosis of acute myocardial infarction

作　　者：田志鹏[1] 孟亮[1] 杨帆[1] 李立杰[1] 王微[1] 

机构地区：[1]沈阳医学院附属中心医院循环内科,辽宁沈阳110024

出　　处：《中国现代医学杂志》2015年第17期30-34,共5页China Journal of Modern Medicine

基　　金：沈阳医学院科技基金(No:20132030)

摘　　要：目的探讨microRNA-1（miR-1）对于急性心肌梗死（AMI）的早期诊断价值。方法急性心肌梗死患者49例,健康体检人群49例。在心肌梗死症状发作后的不同时间段（入院时、发病8 h、发病12 h、发病24 h、发病后第7天和发病后第14天）收集全血标本。应用实时定量PCR检测全血miR-1,应用ELISA法检测血浆肌钙蛋白I（cTn I）。结果 1全血mi R-1在急性心肌梗死发病后的表达量都较对照组增高,在T0[（入院时,（4.98±2.46）h]、T8[AMI发病8 h,（8.00±0.50）h]、T12[AMI发病12 h,（12.00±0.50）h]和T24[AMI发病24 h,（24.00±0.50）h]时间,差异有统计学意义;2全血mi R-1在AMI患者入院时即开始增高,在发病8 h达峰值,T24之后有所下降,7 d降至正常范围;c Tn I在AMI患者入院时即开始增高,在发病24 h达峰值,T24之后有所下降,7 d降至正常范围。mi R-1与c Tn I相比较具有更早的达峰时间;3血清mi R-1的ROC曲线下面积（AUC）在T0（A）、T12（B）和T24（C）分别为0.888（95%置信区间CI：0.812～0.964,P=0.001）、0.906（95%置信区间CI：0.839～0.974,P=0.001）和0.838（95%置信区间CI：0.745～0.931,P=0.001）。结论 AMI患者全血mi R-1表达水平明显增高,且与血浆c Tn I表达水平相比较具有更早的时间窗和达峰值时间,具有诊断AMI良好的早期敏感性,提示未来血清mi R-1可能成为急性心肌梗死早期诊断的新的生物学标记物。【Objective】 To explore the possibility and meaning of micro RNA-1（mi R-1） as a marker of myocardial injury for the diagnosis of acute myocardial infarction（AMI）.【Methods】 The study included 49 patients in the group of AMI, while 49 patients in the normal control group. The blood samples were collected at different time points including the time of admission to hospital（T0）, 8 h（T8）, 12 h（T12）, 24 h（T24）, 7 days（7 d） and 14 days（14 d） after the onset of AMI. Real-time quantitative PCR method was used to detect the expression level of mi R-1 in whole blood and enzyme-linked immunosorbent assay（ELISA） was used for detecting plasma troponin I（c Tn I）. 【Results】 1 The expression levels of whole blood mi R-1 in the patients with acute myocardial infarction at T0, T8, T12 and T24were significantly higher than those in the the control group（ P 0.05）. 2 The whole blood mi RNA-1 level gradually increased and reached the peak level at T8.c Tn I level gradually increased and reached the peak level at T24. Compared with c Tn I, mi RNA-1 had an earlier peak time. Both mi RNA-1 and c Tn I reduced to normal range on the 7th day after onset. 3 The receiver operating characteristic curve（ROC） showed that the area under curve（AUC） of whole blood mi R-1 at the T0,T8 and T12was 0.888（95%CI： 0.812～0.964, P = 0.001）, 0.906（95%CI： 0.839 ～0.974, P = 0.001） and 0.838（95%CI： 0.745～0.931, P = 0.001）. 【Conclusions】 The expression level of mi R-1 is significantly higher in the AMI group than in the control group. In the early stage of AMI, the expression level of mi R-1 has the same time window but earlier peak time compared with c Tn I. It is suggested that the whole blood mi R-1 may be used as a new biomarker in the early diagnosis of AMI.

关 键 词：急性心肌梗死 MICRORNAS 肌钙蛋白I 生物标记物 

分 类 号：R542.22[医药卫生—心血管疾病]