5种血清微小核糖核酸在主动脉夹层患者中的表达变化及联合诊断价值研究  

Expression changes and diagnostic values of 5 serum micrornas in patients with aortic dissection

作　　者：芦洁 陈垚志 李玉琳[1] 刘卓慧 马珂 王绿娅[1] 杜杰[1] LU Jie;CHEN Yaozhi;LI Yulin;LIU Zhuohui;MA Ke;WANG Luya;DU Jie(Beijing Anzhen Hospital,Capital Medi- cal University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beifing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所,100029 [2]吉林大学第一医院心血管疾病诊疗中心 [3]山西医科大学

出　　处：《心肺血管病杂志》2018年第4期337-342,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(91339000)

摘　　要：目的:评价5种血清微小核糖核酸(microRNA)联合在主动脉夹层(AD)患者中的表达变化和联合诊断价值。方法:选择2015年9月至2016年3月期间在北京安贞医院急诊科就诊并最终确诊为主动脉夹层(AD)患者60例为AD组,同时选取年龄性别匹配的在北京安贞医院体检健康者60例为对照组(HC组),采集AD患者入院24h内以及对照组空腹常规血清,根据文献选出5个可能与AD相关的microRNA(has-miR-26a-5p、has-miR-191-5p、has-miR-143-3p、has-miR-21-5p、has-miR-223-3p),采用荧光定量聚合酶链式反应(qRT-PCR)方法检测60例AD患者和60例健康对照(HC)血清中这5种microRNA的表达量,采用2^(-△△CT)方法计算5种microRNA在两组中的相对表达量。通过单个或联合的ROC曲线分析血清microRNA对于AD和HC的区分效能,通过曲线下面积(AUC)评估血清microRNA对于AD的诊断价值。结果:两组研究对象年龄和性别比较差异无统计学意义(P均>0.05);与HC组相比,5种血清microRNA在AD组表达均显著下降(P均<0.05);5个血清microRNA区分AD与HC的曲线下面积(AUC)分别为0.915、0.912、0.910、0.732和0.717(P均<0.05),将AUC>0.9的这3个microRNA联合为Signature^a,Signature^a将AUC提升至0.958(95%CI:0.942~0.992,P<0.05),全部5个microRNA全部联合作为Signature^b,Signature^b将AUC提升至0.964(95%CI:0.935~0.993,P<0.05),所以microRNA联合可以提高AD的诊断效果。结论:5种血清microRNA在AD患者表达变化,联合5种血清microRNA对AD有潜在诊断价值。Objective： To evaluate the diagnostic value of combined 5 serum microRNA in aortic dissection（ AD）. Methods： 60 AD patients who visited Beijing anzhen hospital emergency department in September 2015 to March 2016 and were finally confirmed as AD patients were selected as group AD. 60 healthy person who visited Physical Examination Center at the same time and finally confirmed healthy as group HC. Serum samples were collected in AD patients prior to 24 hours from admission and in healthy person conventionally on an empty stomach. Five specific microRNAs（ has-miR-26 a-5 p、has-miR-191-5 p、has-miR-143-3 p、has-miR-21-5 p、has-miR-223-3 p） were selected according to biological function for further detection. The expression levels of 5 microRNAs were detected in serum of 60 early AD patients and 60 healthy controls（ HC） by quantitative real-time polymerase chain reaction（ qRT-PCR）,comparing the expression changes between the two groups.The relative transcript levels of 5 microRNAs were calculated with the method of 2^（-ΔΔCT）. The efficiency of single or combined serum microRNAs to discriminate AD and HC were conducted by receiver operating characteristic（ ROC） curve. The diagnostic value of serum microRNAs to discriminate AD from HC was evaluated by the area under the curve（ AUC）. Results： The expression levels of 5 serum microRNAs were significantly decreased in AD group compared with HC group（ P〈0. 05）. ROC curve analysis showed the AUC to discriminate AD from HC for 5 serum microRNAs were 0. 915、0. 912、0. 910、0. 732 and 0. 717 respectively（ P〈0. 05）,in which has-miR-26 a-5 p,has-miR-191-5 p and has-miR-143-3 p showing AUCs greater than 0. 9. The three microRNAs were united as Signaturea^a. Signaturea^a elevated AUC up to 0. 958（ 0. 924-0. 992,P〈0. 05）. All 5 microRNAs were jointed as Signature^b. Signature^b elevated AUC up to 0. 964（ 0. 935-0. 993,P〈0. 05）,which means the joint of multiple microRNAs can improve the effect of the diagnosis of AD

关 键 词：主动脉夹层 微小核糖核酸 血清 表达差异 诊断 

分 类 号：R54[医药卫生—心血管疾病]