急性ST段抬高型心肌梗死患者经皮冠状动脉介入术后血清miR-26a-5p水平与心力衰竭的关系  

Relationship between serum miR-26a-5p level and heart failure in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

作　　者：滕赟斌[1] 孙健[1] 初巍巍 姜丽[1] 安娜 TENG Yunbin;SUN Jian;CHU Weiwei;JIANG Li;AN Na(Department of Cardiology,Dalian Third People's Hospital,Dalian,Liaoning 116033,China)

机构地区：[1]大连市第三人民医院心血管内科,辽宁省大连市116033

出　　处：《中国动脉硬化杂志》2021年第10期879-883,共5页Chinese Journal of Arteriosclerosis

基　　金：大连市医学科学研究计划项目(1712024)。

摘　　要：目的探究急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)后血清微小RNA-26a-5p(miR-26a-5p)水平及与心力衰竭的关系。方法选择2018年2月—10月在本院就诊的223例STEMI患者作为研究对象。根据STEMI患者PCI后是否并发心力衰竭将其分为心力衰竭组(n=56)和非心力衰竭组(n=167)。采用实时荧光定量PCR检测STEMI患者外周血中miR-26a-5p水平。比较两组临床资料及miR-26a-5p水平。ROC曲线评价miR-26a-5p对STEMI患者PCI后并发心力衰竭的预测价值。结果心力衰竭组年龄、糖尿病病史、急性前壁型STEMI及发病至治疗时间均高于非心力衰竭组(P<0.05)。两组PCI术前、术后1天和7天miR-26a-5p水平比较有时间效应、组间效应及交互效应(P<0.001)。PCI术后7天miR-26a-5p水平评价STEMI患者并发心力衰竭的ROC曲线下面积高于PCI术前和术后1天(P<0.001)。Logistic回归分析显示,年龄、病变类型、发病至治疗时间和PCI术后7天miR-26a-5p水平与STEMI患者并发心力衰竭密切相关(P<0.05)。结论miR-26a-5p与STEMI患者PCI后并发心力衰竭关系密切,检测PCI后7天miR-26a-5p水平有助于预测心力衰竭的发生。Aim To investigate the relationship between serum microRNA-26a-5p(miR-26a-5p)level and heart failure(HF)in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods 223 patients with STEMI in our hospital from February to October 2018 were selected as the study objects.According to whether patients with STEMI complicated with HF after PCI,they were divided into HF group(n=56)and non-HF group(n=167).The level of miR-26a-5p in peripheral blood of patients with STEMI was detected by real-time fluorescent quantitative PCR.The clinical data and miR-26a-5p levels were compared between the two groups.The predictive value of miR-26a-5p for HF after PCI in STEMI patients was evaluated by ROC curve.Results The age,diabetes history,acute anterior wall STEMI and the time from onset to treatment in HF group were higher than those in non-HF group(P<0.05).There were time effect,inter group effect and interaction effect in the comparison of miR-26a-5p levels before PCI,1 day and 7 days after PCI between the two groups(P<0.001).The area under ROC curve of miR-26a-5p level 7 days after PCI for evaluating STEMI patients complicated with HF was higher than that before PCI and 1 day after PCI(P<0.001).Logistic regression analysis showed that age,lesion type,time from onset to treatment,and miR-26a-5p level 7 days after PCI were closely related to STEMI patients with HF(P<0.05).Conclusions miR-26a-5p is closely related to HF after PCI in STEMI patients.The detection of miR-26a-5p level 7 days after PCI can help to predict the occurrence of HF.

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入术 miR-26a-5p 心力衰竭 

分 类 号：R54[医药卫生—心血管疾病]