血浆microRNA-145表达水平与急性心肌梗死的相关性研究  

Correlation between plasma microRNA-145 levels and acute myocardial infarction

作　　者：肖亚利[1] 赵敏[1] 吕平[1] 刘瑞娟[1] 王金艳[1] 崔涛[1] XIAO Yali ZHAO Min LV Ping LIU Ruijuan WANG Jinyan CUI Tao(Department of Cardiology, Zhuozhou City Hospital, Zhuozhou, Hebei 072750, Chin)

机构地区：[1]涿州市医院心内科,河北涿州072750

出　　处：《中国热带医学》2017年第5期506-510,共5页China Tropical Medicine

基　　金：保定市科学计划与发展指导计划项目(No.15ZF058)

摘　　要：目的探讨血浆microRNA-145在急性心肌梗死(AMI)中的表达及相关性。方法选取2015年1月—2016年10月河北省涿州市医院院就诊的疑似AMI患者282例,根据AMI诊断标准将患者分为AMI组174例与非AMI组108例;以同期健康体检者85例作为对照组。AMI患者分别于发病3、8、24、72、120和168 h采用荧光定量反转录-聚合酶链反应(RT-PCR)检测血浆microRNA-145含量,电化学发光法检测心肌肌钙蛋白I(cTnI)及肌红蛋白(Mb)水平。应用受试者工作特征曲线(ROC)分析血浆microRNA-145、cTnI及Mb对AMI的诊断价值,Logistic回归模型分析血浆microRNA-145与AMI的关系。Spearman秩相关分析AMI患者血浆microRNA-145水平与cTnI、Mb的相关性。结果 AMI组和非AMI组血浆microRNA-145(2^(-ΔΔCt))分别为1.06±0.25和0.48±0.12,cTnI分别为2.96(0.56,10.28)ng/mL和0.05(0.01,0.23)ng/mL,Mb分别为87.35(68.42,139.34)ng/mL和43.62(30.28,70.41)ng/mL,均高于对照组的0.07±0.01、0.00(0.00,0.00)ng/mL和19.53(11.46,32.53)ng/mL,差异有统计学意义(P<0.05)。与cTnI和Mb相比,血浆microRNA-145水平在AMI患者中出现较早,3 h开始升高(0.72±0.16),8 h达到高峰(1.84±0.52),在7 d仍可见microRNA-145高表达。血浆microRNA-145最佳临界值为0.72时,其诊断AMI的敏感度和特异度最好,分别为86.4%和91.3%。Logistic回归分析显示,血浆microRNA-145及cTnI是AMI患者的独立危险因素(P<0.05)。AMI患者血浆microRNA-145与cTnI呈正相关(r=0.586,P<0.01)。结论血浆microRNA-145在AMI中具有较高的敏感度和特异度,可作为早期诊断AMI的生物学指标。Objective To investigate the correlation between plasma microRNA-145 expression levels and acute myocardial infarction （AMI）. Methods From January 2015 to October 2016, 282 cases of suspected AMI patients in Zhuozhou City Hospital of Hebei Province were divided into an AMI group （174 cases） and a non-AMI group （108 cases） according to the diagnostic criteria of AMI, and 85 healthy physical examination persons were selected as a control group. The microRNA-145 expression levels of the AMI patients, non-AMI patients and persons of the control group were detected by the fluorescent quantitative reverse transcription polymerase chain reaction （RT-PCR） in the incidence of 3, 8, 24, 72, 120, 168 hours, and the cardiac troponin I （cTnI） and myoglobin （Mb） levels were measured by the electrochemical luminescence. The diagnostic values of plasma microRNA- 145, cTnI and Mb for AMI were estimated by the receiver operating characteristic （ROC） curve analysis, and the relationship between plasma microRNA-145 and AMI was analyzed by the logistic regression model. The correlation between plasma microRNA-145 and cTnI as well as Mb was performed by Spearman analysis. Results Compared with the control group, the levels of plasma microRNA-145, cTnI and Mb were increased in the non-AMI group, and increased more significantly in the AMI group [microRNA-145 （2-△△Cr）： 0.07＋0.01 vs 0.48＋0.12 and 1.06±0.25; cTnI （ng/mL）： 0.00 （0.00, 0.00） vs 0.05 （0.01, 0.23） and 2.96 （0.56, 10.28）; Mb （ng/mL）： 19.53 （11.46, 32.53） vs 43.62 （30.28, 70.41） and 87.35 （68.42, 139.34）, all P〈0.05]. Compared with eTnI and Mb, the plasma level of microRNA- 145 appeared earlier in the patients with AMI [increased in 3 hours （0.72＋0.16）, and peaked in 8 hours （1.84±0.52）], and in 7 days, the high expression of microRNA-145 could still be seen. The optimal threshold value of plasma microRNA-145 was 0.72, which had the best sensitivity and specificity of the diagnostic AMI,

关 键 词：急性心肌梗死 microRNA-145 生物学标记 敏感度 特异度 

分 类 号：R542.22[医药卫生—心血管疾病]