老年非ST段抬高心肌梗死患者血清miR-223、PAPP-A水平表达的临床意义  

Clinical significance of miR-223 and PAPP-A levels in the elderly patients with non-ST-segment elevation myocardial infarction

作　　者：张伯超[1] 邹剑杰[1] 钟正龙 ZHANG Bochao;ZOU Jianjie;ZHONG Zhenglong(Department of Cardiology,Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀枝花市中西医结合医院心内科,四川攀枝花617000

出　　处：《国际检验医学杂志》2022年第17期2075-2079,2085,共6页International Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(81500224);四川省卫生健康委员会科研课题(19PJ427)。

摘　　要：目的分析老年非ST段抬高心肌梗死(NSTEMI)患者血清微小核糖核酸(miR)-223、妊娠相关血浆蛋白-A(PAPP-A)水平表达的临床意义,并分析二者对预后的影响。方法选取2019年2月至2020年2月该院收治的120例NSTEMI患者作为观察组,并选取该院同期收治的120例老年不稳定型心绞痛(UAP)患者作为对照组。检测、对比两组入院时血清miR-223、PAPP-A水平;全部NSTEMI患者出院后随访1年,并根据随访期间主要心血管不良事件(MACE)的发生情况分为预后良好组和预后不良组,设计一般资料调查表,记录基线资料及实验室指标,重点分析入院时血清miR-223、PAPP-A水平对患者预后的影响。结果观察组血清PAPP-A水平、miR-223相对表达量均高于对照组,差异有统计学意义(P<0.05);120例老年NSTEMI患者中,随访1年结束时,有50例患者发生MACE,发生率为41.67%;对比预后不良组与预后良好组基线资料及实验室指标后,经回归分析结果显示,老年NSTEMI患者入院当天的血清PAPP-A水平高、miR-223相对表达量高表达是老年NSTEMI患者预后不良的危险因素(OR>1,P<0.05);绘制受试者工作特征(ROC)曲线,老年NSTEMI患者入院当天的血清PAPP-A水平、miR-223相对表达量预测老年NSTEMI患者预后不良风险的曲线下面积(AUC)均>0.70,预测价值较理想,且以联合预测的价值最好。结论血清miR-223相对表达量、PAPP-A水平与NSTEMI的发生有关,且血清miR-223相对表达量、PAPP-A水平能够对NSTEMI患者预后产生影响。Objective To investigate the clinical significance of the expression of microRNA(miR)-223 and pregnancy-associated plasma protein-A(PAPP-A)in elderly patients with non-ST-segment elevation myocardial infarction(NSTEMI),and to analyze the influence of the two factors on prognosis.Methods A total of 120 elderly patients with NSTEMI treated in the hospital from February 2019 to February 2020 were prospectively selected as the observation group,120 elderly patients with unstable angina pectoris(UAP)treated in the hospital in the same period were selected as the control group.The serum miR-223 and PAPP-A levels at admission were detected and compared in the two groups.All NSTEMI patients were followed up for 1 year after discharge,the occurrance of major cardiovascular adverse events(MACE)were recorded during the follow-up,and accordingly the patients were divided into a good prognosis group and a poor prognosis group.The general data questionnaire was designed,baseline data and laboratory indexes were recorded,and the influence of miR-223 and PAPP-A at admission on the prognosis of patients was mainly analyzed.Results The serum PAPP-A level and miR-223 relative expression in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).At the end of one-year follow-up,among 120 elderly patients with NSTEMI,50 patients had MACE,the incidence rate was 41.67%.After comparing the baseline data and laboratory indexes between the poor prognosis group and the good prognosis group,regression analysis results showed that the high level of PAPP-A and the high relative expression of miR-223 were the risk factors of poor prognosis in the elderly patients with NSTEMI(OR>1,P<0.05).The receiver operating characteristic(ROC)curve was drawn,the area under curve(AUC)of serum PAPP-A level and miR-223 relative expression at admission of elderly patients with NSTEMI in predicting the risk of poor prognosis were all>0.70,the predicted value was ideal and the combined detection

关 键 词：非ST段抬高心肌梗死 老年 微小核糖核酸-223 妊娠相关血浆蛋白A 预后 

分 类 号：R542.22[医药卫生—心血管疾病]