血清外泌体miR-122及miR-194在心肌梗死患者中诊断早期心衰的价值  

Diagnostic value of serum exosomal miR-122 and miR-194 in early heart failure after myocardial infarction

作　　者：孙晓燕 亓良森 赵海鸿 周洪伟 马靖[2] SUN Xiaoyan;QI Liangsen;ZHAO Haihong;ZHOU Hongwei;MA Jing(Department of Internal Medicine,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China;Department of Healthy Medicine,the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]北京市大兴区中西医结合医院内三科,北京100076 [2]解放军总医院第二医学中心健康医学科,北京100853

出　　处：《解放军医学院学报》2021年第9期940-945,共6页Academic Journal of Chinese PLA Medical School

摘　　要：背景目前我国急性心肌梗死发病率迅速增长,心梗后心衰防治现状不容乐观。目的探讨血清外泌体miR-122及miR-194在心肌梗死早期的动态变化,为心梗后心衰的早期诊断提供参考。方法选取北京市大兴区中西医结合医院2018年1月-2020年6月收治的96例急性心肌梗死患者,所有患者均接受经皮冠状动脉介入治疗,并根据急性心肌梗死(acute myocardial infarction,AMI)后是否发生心力衰竭,分为AMI后发生心力衰竭组(35例)和未发生心衰组(61例)。采用逆转录聚合酶链反应技术(RT-PCR)检测并比较两组患者术后1 h以及发病后12 h、20 h、24 h和48 h静脉血血清miR-122、miR-194水平以及N-末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度,并采用Pearson相关性分析法分析血清miR-122、miR-194水平与NT-proBNP浓度的相关性。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析患者各时间点的miR-122、miR-194表达水平对心衰发生的诊断价值。结果经整体分析(两因素重复测量方差分析)知各指标的组间、时间及交互作用的整体差异均有统计学意义(P<0.05)。组内比较:两组术后1 h以及发病后12 h、20 h、24 h和48 h静脉血血清NT-proBNP浓度以及miR-194水平均呈先上升后下降趋势,并于发病后24 h达到峰值的单峰趋势,miR-122水平呈现先下降后上升趋势,发病后24 h时间点相对表达水平最低;组间比较:除术后1 h时间点外,AMI后发生心力衰竭组患者各时间点的血清NT-proBNP浓度、miR-194水平均高于未发生心衰组,miR-122水平低于未发生心衰组,差异均存在统计学意义(P<0.05)。Pearson相关性分析结果显示血清miR-122表达水平与NT-proBNP呈显著负相关(r=-0.667,P=0.012),血清miR-194表达水平与NT-proBNP呈显著正相关(r=0.854,P=0.004)。ROC分析结果显示,除AMI患者术后1 h miR-122和miR-194水平对心衰不具有较佳诊断价值外,其余时间点的miR-1Background At present,the incidence of acute myocardial infarction is increasing rapidly in China,while the prevention and treatment of heart failure after myocardial infarction is not optimistic.Objective To investigate the dynamic changes of serum exosomal microRNA(microRNA,miR)-122 and miR-194 in the early stage of myocardial infarction and provide reference for the early diagnosis of heart failure after myocardial infarction.Methods From January 2018 to June 2020,96 patients with acute myocardial infarction admitted to Beijing Daxing District Hospital of Integrated Chinese and Western Medicine were selected.All patients received percutaneous coronary intervention(PCI)treatment,and based on whether heart failure occurred after AMI,they were divided into heart failure after AMI group(n=35)and non-heart failure group(n=61).Reverse transcription polymerase chain reaction(RT-PCR)was used to detect and compare the levels of serum miR-122,miR-194 and Precursor(N-terminal pro-brain natriuretic peptide,NT-proBNP)concentration in the venous blood of the two groups at 1 h,12 h,20 h,24 h and 48 h after onset,and Pearson correlation was used to analyze the correlation between serum miR-122,miR-194 levels and NT-proBNP concentration.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of miR-122 and miR-194 expression levels at each time point in patients with heart failure.Results Overall analysis(two factor repeated measurement analysis of variance)revealed that there were statistically significant differences in indexes,time and interaction between the groups(P<0.05).The venous blood serum NT-proBNP concentration and miR-194 level of the two groups increased at 1 h,12 h,20 h,24 h and 48 h after the onset,and then decreased,and peaked at 24 h after onset;The level of miR-122 showed a trend of first decrease and then increase,and the relative expression level was the lowest at 24 h after the onset.Except for the time point of 1 h after operation,the serum NT-proBNP concentration and miR

关 键 词：MIR-122 miR-194 心肌梗死 心力衰竭 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]