肺超声联合血浆外泌体miR-223检测在急性心肌梗死中的应用  

Value of lung ultrasound combined with detection of plasma exosomal miR-223 in acute myocardial infarction

作　　者：赵娟[1] 柴仁杰 杨泽福 潘伟[3] Zhao Juan;Chai Renjie;Yang Zefu;Pan Wei(Department of Ultrasound Medicine,Nanhai District People's Hospital and Sixth Affiliated Hospital of South China University of Technology,Foshan,Guangdong 528200;Guangzhou Institute of Cardiovascular Diseases,Guangzhou 510260;Department of Cardiology,Nanhai District People's Hospital and Sixth Affiliated Hospital of South China University of Technology,Foshan,Guangdong 528200,China)

机构地区：[1]华南理工大学附属第六医院,南海区人民医院超声科,广东佛山528200 [2]广州心血管疾病研究所,广东广州510260 [3]华南理工大学附属第六医院,南海区人民医院心内科,广东佛山528200

出　　处：《广州医科大学学报》2022年第1期18-22,共5页Academic Journal of Guangzhou Medical University

基　　金：佛山市医学科技攻关项目(2020001004341);佛山市杰出青年医学人才计划项目(201803)。

摘　　要：目的:探讨肺超声(LUS)联合血浆外分泌体miR-223检测在左心室射血分数(LVEF)≥50%的急性心肌梗死(AMI)患者近期预后评估中的作用。方法:随机入选95例AMI患者,包括近期预后良好组(47例)和预后不良组(48例)。用LUS检测B线积分,用real-time PCR法检测血浆miR-223的含量。研究预后不良组B线积分和血浆miR-223的变化。用Pearson相关性分析AMI患者B线积分和血浆miR-223的关系。用Logistic回归研究B线积分和血浆miR-223是否是AMI患者近期预后不良的独立预测因子。通过受试者工作特征曲线(ROC曲线)分析左心室整体纵向应变(LV-GLS)和miR-223以及二者联合预测AMI近期预后的价值。结果:与近期预后良好组比较,预后不良组AMI患者B线积分增加(4.21±1.46比9.02±3.18)、血浆miR-223升高[(2.99±1.15)2^(-ΔΔct)*10^(4)比(6.00±2.09)2^(-ΔΔct)*10^(4)](P<0.05).AMI患者B线积分和血浆miR-223水平呈正相关(r=0.704,P=0.000)。B线积分和血浆miR-223升高(OR分别为1.56、1.87,P<0.05)是AMI患者近期预后不良的独立预测因子。预测AMI近期预后的ROC曲线显示:B线积分、miR-223、B线积分联合miR-223的AUC分别为0.882(95%CI0.806-0.957)、0.884(95%CI0.805-0.963)和0.897(95%CI0.822-0.972);敏感度分别为79.2%、83.3%和89.6%;特异度分别为97.9%、91.5%和91.5%。结论:LUS联合血浆miR-223检测对AMI近期预后不良有预测价值。Objective:To investigate the value of lung ultrasound(LUS)combined with detection of plasmaexosomal miR-223 in short-term prognostification of acute myocardial infarction(AMI)patients with≥50%leftventricular ejection fraction(LVEF).Methods:A total of 95 AMI patients with were randomly included andassigned to a group with favorable short-term prognosis(n=47)and a group with poor short-term prognosis(n=48).For these patients,LUS was used to measure the B-line score,and real-time PCR was used to measure thelevel of plasma miR-223.The changes in B-line scores and plasma miR-223 level in patients with poor prognosiswere investigated.The relationship between B-line score and plasma miR-223 in AMI patients was determined byPearson correlation analysis.Logistic regression was used to investigate whether the B-line score and plasma miR-223 level were independent predictors of poor short-term prognosis in AMI patients.The value of left ventricular global longitudinal strain(LV-GLS)and miR-223,used alone or in combination for predicting the short-termprognosis of AMI,was analyzed by receiver operating characteristic(ROC)curve.Results:Compared with AMIpatients with favorable short-term prognosis,those with poor short-term prognosis had higher B-line score(4.21±1.46vs.9.02±3.18)and plasma miR-223 level[(2.99±1.15)2^(-ΔΔct)*10^(4) vs(6.00±2.09)2^(-ΔΔct)*10^(4)](P<0.05).The B-line score were positively correlated with plasma miR-223 levels in AMI patients(r=0.704,P=0.000).Increases in B-line score(OR=1.56,P<0.05)and plasma miR-223 level(OR=1.87,P<0.05)wereindependent predictors of poor short-term prognosis in patients with AMI.Prediction of short-term prognosis inAMI patients by ROC curve analysis showed that the AUCs of B-line score,miR-223,and B-line score combinedwith miR-223 were 0.882(95%CI0.806-0.957),0.884(95%CI0.805-0.963),and 0.897(95%CI0.822-0.972),respectively,yielding a sensitivity of 79.2%,83.3%and 89.6%,and a specificity of 97.9%,91.5%and91.5%,respectively.Conclusion:LUS combined with plasma miR-223 dete

关 键 词：肺超声 微RNAS 急性心肌梗死 心力衰竭 

分 类 号：R543.3[医药卫生—心血管疾病]