糖尿病合并急性心肌梗死病人血清环状RNA-CDR1as表达及其临床价值分析  

Clinical Value of Serum Circular RNA-CDR1as in Patients with Diabetes Mellitus Complicated with Acute Myocardial Infarction

作　　者：惠丽超 邱刚 赵韧[3] HUI Lichao;QIU Gang;ZHAO Ren(Jinzhou Central Hospital,Jinzhou 121000,Liaoning,China)

机构地区：[1]锦州市中心医院,辽宁锦州121000 [2]北镇市人民医院 [3]中国人民解放军沈阳军区总医院

出　　处：《中西医结合心脑血管病杂志》2020年第9期1425-1428,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：2017年辽宁省自然科学基金指导计划立项项目(No.201702326)。

摘　　要：目的探讨环状RNA-CDR1as(circRNA-CDR1as)在糖尿病合并急性心肌梗死病人中的表达情况,并分析其早期诊断价值、疗效评估价值及近期预后预测价值。方法选取2014年10月-2018年10月锦州市中心医院收治的175例AMI病人作为研究对象,根据口服葡萄糖耐量试验(OGTT)分为糖尿病合并急性心肌梗死(DM-AMI)组80例、糖耐量异常合并急性心肌梗死(IGT-AMI)组55例和糖耐量正常合并急性心肌梗死(NGT-AMI)组40例。同期50名健康体检者作为健康对照组。采用实时荧光定量聚合酶链反应(FQ-PCR)检测4组血清circRNA-CDR1as水平;根据临床特征及实验室数据计算病人全球急性冠状动脉事件注册(GRACE)评分,并记录住院期间病人预后情况。采用ROC曲线分析血清circRNA-CDR1as对糖尿病合并急性心肌梗死的诊断价值;比较DM-AMI组、IGT-AMI组、NGT-AMI组治疗前后血清circRNA-CDR1as水平;比较生存和死亡病人血清circRNA-CDR1as水平和GRACE评分差异;采用Spearman法分析circRNA-CDR1as与GRACE评分的相关性。结果DM-AMI组、IGT-AMI组、NGT-AMI组和健康对照组血清circRNA-CDR1as分别为4.98±1.56、4.57±1.28、2.81±0.69和1.02±0.25,4组比较差异有统计学意义(P<0.05),由高到低依次为DM-AMI组、IGT-AMI组、NGT-AMI组和健康对照组。绘制ROC曲线,曲线下面积为0.819(95%CI 0.694~0.998,P<0.05),截断值为3.28,敏感度和特异度分别为98.3%和60.0%。治疗后DM-AMI组、IGT-AMI组和NGT-AMI组血清circRNA-CDR1as均较治疗前明显降低(P<0.05),3组血清circRNA-CDR1as治疗前后差值比较差异有统计学意义(P<0.05),由大到小依次为DM-AMI组、IGT-AMI组和NGT-AMI组。住院期间,175例AMI病人中35例死亡,140例生存;与生存病人比较,死亡病人血清circRNA-CDR1as水平明显升高,且GRACE评分中高危占比大,差异均有统计学意义(P<0.05)。经Spearman法分析显示,血清circRNA-CDR1as水平与GRACE评分分组呈正相关(r=0.729,P<0.05)。结论AMI病人血清circObjective To investigate the expression of circular RNA-CDR1as(circRNA-CDR1as)in patients with diabetes mellitus(DM)complicated with acute myocardial infarction(AMI),and to analyze its early diagnostic value,therapeutic value,and short-term prognostic value.Methods One hundred and seventy-five patients were selected,included 80 cases DM complicated with AMI patients(DM-AMI group),55 cases impaired glucose tolerance(IGT)complicated with AMI patients(IGT-AMI group),40 cases normal glucose tolerance(NGT)complicated with AMI patients(NGT-AMI group),and 50 healthy subjects were selected as healthy control group.Merhods Real-time quantitative PCR(FQ-PCR)was used to detect serum circRNA-CDR1as levels.The global acute coronary event registration(GRACE)score was calculated based on clinical features and laboratory data,and survival situation was recorded.The diagnostic value of serum circRNA-CDR1as for diabetic patients with acute myocardial infarction was analyzed by ROC curve.Serum circRNA-CDR1as levels were compared before and after treatment in DM-AMI group,IGT-AMI group,and NGT-AMI group.The serum circRNA-CDR1as level and GRACE score were compared between surviving and died patients.The relationship between circRNA-CDR1as and GRACE score was analyzed by Spearman method.Results Serum circRNA-CDR1as in DM-AMI group,IGT-AMI group,NGT-AMI group,and healthy control group were 4.98±1.56,4.57±1.28,2.81±0.69,1.02±0.25,respectively.The difference between the four groups was statistically significant(P<0.05).The ROC curve was plotted.The area under the curve was 0.819(95%CI 0.694~0.998,P<0.05),the cutoff value was 3.28,and the sensitivity and specificity were 98.3%and 60%,respectively.Compared with dafa before treatment,serum circRNA-CDR1as was significantly decreased in DM-AMI group,IGT-AMI group,and NGT-AMI group after treatment,and the differences were statistically significant(P<0.05).During hospitalization,35 AMI patients died and 140 survived.Compared with survivors,serum circRNA-CDR1as level was significantly higher

关 键 词：糖尿病 急性心肌梗死 环状RNA-CDR1as 糖耐量异常 GRACE评分 

分 类 号：R542.2[医药卫生—心血管疾病] R256.2[医药卫生—内科学]