血miR-155在急性心肌梗死后恶性心律失常中的临床价值  

Clinical value of serum miR-155 to malignant arrhythmia after acute myocardial infarction

作　　者：白净[1] 徐晶[2] 杨禹娟[1] Bai Jing;Xu Jing;Yang Yujuan(Third Department of Cardiovascular Medicine,People's Hospital of Shaanxi Provincial,Xi`an 710068,Xi`an,China;不详)

机构地区：[1]陕西省人民医院心血管内三科,西安710068 [2]陕西省人民医院心血管内一科,西安710068

出　　处：《中国循证心血管医学杂志》2022年第8期944-947,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：陕西省自然科学基础研究计划项目(2019JM-530)。

摘　　要：目的探讨血微小核糖核酸-155(miR-155)在急性心肌梗死(AMI)后恶性心律失常中的临床价值。方法选取172例AMI患者作为研究对象,根据是否并发恶性心律失常分为恶性组(n=40)和非恶性组(n=132),同期选取40例健康志愿者作为对照组。采用实时荧光定量聚合酶反应(qRT-PCR)检测各组血miR-155水平并进行对比,绘制受试者工作特征曲线(ROC曲线)分析其诊断价值;所有患者均给予了心电图检测,收集各组T波峰-末间期(Tp-Te)、碎裂状QRS波(fQRS)、缺血性J波和新发房颤发生情况;用Spearman相关分析miR-155与Tp-Te、fQRS、J波和心房颤动的关联。结果恶性组、无恶性组和对照组血miR-155相对表达水平分别为(5.36±1.57)、(2.75±0.64)和(1.28±0.32),三组比较差异有统计学意义(P<0.001),其中无恶性组高于对照组(P<0.001),恶性组高于无恶性组(P=0.015)。与无恶性组比较,恶性组Tp-Te延长,fQRS、缺血性J波及新发房颤发生率升高,差异均有统计学意义(P<0.05)。Spearman相关分析发现,Tp-Te、fQRS、缺血性J波及心房颤动发生与血miR-155均呈正相关(r=0.612,r=0.674,r=0.625,r=0.644;P均<0.001)。绘制ROC曲线分析发现,血miR-155可辅助诊断AMI(P<0.05),其曲线下面积(AUC)为0.781,在最佳截断值为2.58时,灵敏度和特异度分别为84.3%和71.6%;血miR-155可预测AMI后恶性心律失常(P<0.05),其AUC为0.824,在最佳截断值为4.76时,灵敏度和特异度分别为88.9%和73.5%。结论MiR-155与Tp-Te延长、fQRS、缺血性J波或心房颤动发生相关,在AMI诊断及AMI后恶性心律失常预测上具有一定价值。Objective To investigate the clinical value of serum microRNA-155(miR-155)to malignant arrhythmia after acute myocardial infarction(AMI).Methods AMI patients(n=172)were chosen as study subjects,and divided,according to whether or not malignant arrhythmia occurred,into malignant group(n=40)and non-malignant group(n=132).At the same time the healthy volunteers(n=40)were chosen into control group.The level of serum miR-155 was detected and compared in all groups by using real-time fluorescence quantitative polymerase chain reaction(qRT-PCR),and diagnostic value of serum miR-155 was analyzed by using receiver operating characteristic(ROC)curve.All patients were given ECG examination,and the occurrence of T wave peak-end interval(Tp-Te),fragmented QRS complex(fQRS),ischemic J wave and incidence of new-onset atrial fibrillation(AF)were collected in all groups.The correlation among miR-155,Tp-Te,fQRS,J wave and new-onset AF was analyzed by using Spearman correlation analysis.Results The correlative expression level of serum miR-155 was(5.36±1.57)in malignant group,(2.75±0.64)in non-malignant group and(1.28±0.32)in control group and difference had statistical significance among 3 groups(P<0.001),and that was higher in non-malignant group than that in control group(P<0.001)and that was higher in malignant group than that in non-malignant group(P=0.015).Compared with non-malignant group,Tp-Te prolonged and incidence rates of fQRS,ischemic J wave and new-onset AF increased in malignant group(P<0.05).The results of Spearman correlation analysis showed that Tp-Te(r=0.612),fQRS(r=0.674),ischemic J wave(r=0.625)and new-onset AF(r=0.644)all were positively correlated to serum miR-155(all P<0.001).The results of ROC curve analysis showed that serum miR-155 had an assistant effect in AMI diagnosis(P<0.05),AUC was 0.781,sensitivity was 84.3%and specificity was 71.6%when the optimal cutoff value was 2.58.The level of serum miR-155 could predict malignant arrhythmia after AMI(P<0.05),AUC was 0.824,sensitivity was 88.9%and specific

关 键 词：急性心肌梗死 恶性心律失常 微小核糖核酸-155 相关分析 受试者工作特征曲线 

分 类 号：R542.22[医药卫生—心血管疾病]