循环微小RNA-16在急性心肌梗死早期诊断中的价值  

Diagnostic value of cyclic miR-16 in early acute myocardial infarction

作　　者：朱静[1] 罗旺胜 汪俊军 杨锴[1] ZHU Jing;LUO Wang-sheng;WANG Jun-jun;YANG Kai(Department of Cardiology,Wuhan Xinzhou District People＇s Hospital,Hubei,Wuhan 430400,China)

机构地区：[1]武汉市中心医院新洲院区(武汉市新洲区人民医院)心内科,湖北武汉430400

出　　处：《中国临床研究》2018年第10期1323-1326,共4页Chinese Journal of Clinical Research

摘　　要：目的检测急性心肌梗死(AMI)患者血浆中微小核糖核酸-16(microRNA-16,miR-16)的表达水平,并分析其对AMI早期诊断的价值。方法收集2014年1月至2016年12月在武汉市新洲人民医院心内科确诊的200例AMI患者作为AMI组,以同期本院200例健康体检者作为对照组。对AMI组患者发病0、6、12及24 h及对照组,采用荧光定量聚合酶链式反应(FQ-PCR)检测其血浆miR-16表达水平,采用酶联免疫吸附法(ELISA)测定其血浆心肌肌钙蛋白I(cTnI)及肌红蛋白(Mb)含量。分析AMI组患者血浆miR-16表达水平与cTnI及Mb水平的相关性,受试者工作特征曲线(ROC)分析AMI组患者血浆miR-16表达水平对AMI的诊断价值。结果对照组血浆miR-16的表达量为1. 00±0. 17,AMI组患者发病0、6、12及24 h血浆miR-16的表达量分别为1. 73±0. 32、2. 75±0. 44、2. 63±0. 47及2. 36±0. 28,较对照组显著增高(P均<0. 05)。对照组血浆cTnI含量为(33. 24±7. 32) pg/ml,AMI组患者发病0、6、12及24 h血浆cTnI含量分别为(417. 73±36. 54) pg/ml、(779. 28±88. 25) pg/ml、(1 329. 45±221. 06) pg/ml及(1 154. 22±156. 39) pg/ml,较对照组显著增高(P均<0. 05)。对照组血浆Mb含量为(21. 55±4. 67) U/L,AMI组患者发病0、6、12及24 h时血浆Mb含量分别为(26. 89±7. 22) U/L、(71. 43±16. 52) U/L、(152. 18±26. 34) U/L及(94. 17±18. 16) U/L,除0 h外,均较对照组显著增高(P均<0. 05)。AMI组患者血浆miR-16表达水平与cTnI(r=0. 41,P <0. 05)和Mb(r=0. 27,P <0. 05)含量分别呈正相关。ROC曲线分析显示,miR-16对AMI诊断的ROC曲线下面积为0. 86(95%CI:0. 81～0. 90),当miR-16的临界值(截点)为2. 17时,其敏感度和特异度分别为84. 74%和74. 57%。结论 miR-16在AMI患者血浆中的表达明显高于健康人群;高表达的miR-16在AMI诊断中具有较高的敏感度和特异度,拟可作为早期诊断AMI的生物学指标。Objective To detect the expression level of plasma microRNA-16（miR-16） in the patients with acute myocardial infarction（AMI） and explore the value of miR-16 on early diagnosis of AMI. Methods A total of 200 AMI patients（AMI group） and 200 healthy controls（control group） were recruited between January 2014 and December 2016.The expression levels of miR-16 in plasma were detected by FQ-PCR at 0-,6-,12-and 24-hour after onset of AMI,and plasma concentrations of cardiac troponin I（cTnI） and myoglobin（Mb） were measured by ELISA. Associations of the expression level of miR-16 in plasma with cTnI and Mb levels in AMI patients were analyzed,and the diagnostic value of plasma miR-16 expression level was analyzed by ROC curve. Results The miR-16 expression levels in plasma were 1. 73± 0. 32,2. 75 ± 0. 44,2. 63 ± 0. 47 and 2. 36 ± 0. 28 at 0-,6-,12-and 24-h,respectively in AMI group and significantly increased compared with that（1. 00 ± 0. 17） in control group（all P〈0.05）. The plasma concentrations of cTnI were（417. 73 ± 36. 54） pg/ml,（779. 28 ± 88. 25） pg/ml,（1 329. 45 ± 221. 06） pg/ml and（1 154. 22 ± 156. 39） pg/m L at 0-,6-,12-and 24-h,respectively in AMI group and were obviously higher than that（33. 24 ± 7. 32） pg/ml in control group（all P〈0.05）. Mb levels in plasma were（26. 89 ± 7. 22） U/L,（71. 43 ± 16. 52） U/L,（152. 18 ± 26. 34） U/L and（94. 17 ±18. 16） U/L at 0-,6-,12-and 24-h,respectively in AMI group and were significantly higher than that（21. 55 ± 4. 67） U/L in control group（all P〈0.05）. Expression level of miR-16 in plasma was positively correlated with contents of cTnI（r =0. 41,P〈0.05） and Mb（r = 0. 27,P〈0.05） respectively in AMI group. ROC curve analysis showed that the area under the ROC curve of miR-16 for AMI diagnosis was 0. 86（95% CI： 0. 81-0. 90）. When the critical value（cut-off point） of miR-16 was 2. 17,the sensitivity and specificity were 84. 74% and 74. 57%,respectively. Conclusion

关 键 词：微小核糖核酸-16 肌钙蛋白Ⅰ 急性心肌梗死 诊断效能 

分 类 号：R543.31[医药卫生—心血管疾病]