老年急性心肌梗死患者PCI前血清miR-503、Apelin-13水平与术后左心室重构的关系  

Relationships between preoperative serum miR-503 and Apelin-13 expression levels and left ventricu⁃lar remodeling after PCI in elderly patients with acute myocardial infarction

作　　者：陈君 马娜 顾明 彭洋[2] CHEN Jun;MA Na;GU Ming;PENG Yang(Department of Cardiology,Tianjin Occupational Disease Prevention and Treatment Hospital,Tianjin 300011,China;不详)

机构地区：[1]天津市职业病防治院(天津市工人医院)心血管内科,天津300011 [2]天津市职业病防治院(天津市工人医院)中西医结合科

出　　处：《山东医药》2022年第34期11-15,共5页Shandong Medical Journal

基　　金：天津市卫生行业重点攻关项目(19KG117)。

摘　　要：目的分析老年急性心肌梗死(AMI)患者术前血清微小RNA-503(miR-503)、孤独G蛋白偶联受体配体-13(Apelin-13)水平与经皮冠状动脉介入治疗(PCI)术后左心室重构(LVR)的关系。方法选取行PCI治疗的老年AMI患者143例作为观察组,体检健康者140例作为对照组。分别采用实时荧光定量PCR、酶联免疫吸附法检测观察组PCI术前和对照组体检时血清miR-503、Apelin-13水平;术后1年检测老年AMI患者超声心动图指标[左心室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左室射血分数(LVEF)],根据是否发生LVR将患者分为LVR组61例、非LVR组82例;Pearson法分析LVR患者术前血清miR-503、Apelin-13、术后1年超声心动图指标的相关性,采用多因素Logistic回归分析影响老年AMI患者PCI术后1年发生LVR的因素,受试者工作特征(ROC)曲线分析术前血清miR-503、Apelin-13对老年AMI患者PCI术后1年发生LVR的预测价值。结果与对照组比较,观察组术前血清miR-503水平升高,Apelin-13水平降低(P均<0.05);与非LVR组比较,LVR组术前血清miR-503水平、术后1年LVEDD、IVST、LVPWT升高,术前Apelin-13水平、术后1年LVEF降低(P均<0.05)。LVR患者术前血清miR-503与Apelin-13呈负相关(r=-0.544,P<0.05);术前血清miR-503与术后1年LVEDD、IVST、LVPWT呈正相关(r分别为0.491、0.628、0.477,P均<0.05),与LVEF呈负相关(r=-0.562,P<0.05);术前血清Apelin-13与术后1年LVEDD、IVST、LVPWT呈负相关(r分别为-0.514、-0.583、-0.609,P均<0.05),与LVEF呈正相关(r=0.465,P<0.05)。血清miR-503水平及LVEDD、IVST、LVPWT均是影响老年AMI患者PCI术后1年发生LVR的危险因素,血清Apelin-13水平及LVEF则为其保护因素(P均<0.05);术前血清miR-503、Apelin-13及二者联合预测老年AMI患者PCI术后1年发生LVR的ROC曲线下面积(AUC)分别为0.803、0.839、0.927,二者联合AUC高于血清miR-503、Apelin-13单独预测(P均<0.05)。结论老年AMI患者PCI术前血清miR-503呈�Objective To analyze the relationships between preoperative serum microRNA-503(miR-503),Apelin-13 expression levels and left ventricular remodeling(LVR)after percutaneous coronary intervention(PCI)in elderly pa⁃tients with acute myocardial infarction(AMI).Methods Totally 143 elderly AMI patients(the observation group)and 140 healthy people(the control group)were selected.Real-time fluorescent quantitative PCR and enzyme-linked immuno⁃sorbent assay were used to detect the levels of serum miR-503 and Apelin-13 before PCI in the observation group and dur⁃ing physical examination in the control group.One year after operation,echocardiographic indexes[left ventricular end-di⁃astolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT)and left ventricular ejection fraction(LVEF)]were measured in elderly patients with AMI,and then patients were divided into the LVR group of 61 cases and non-LVR group of 82 cases according to whether LVR occurred or not.Pearson method was used to analyze the correlation between preoperative serum miR-503,Apelin-13 and echocardiographic indexes one year after operation in patients with LVR.Multivariate Logistic regression was used to analyze the factors for LVR in elder⁃ly patients with AMI one year after PCI.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of preoperative serum miR-503,Apelin-13 on LVR in elderly patients with AMI at 1 year after PCI.Results Com⁃pared with the control group,the expression level of preoperative serum miR-503 was significantly higher and the expres⁃sion level of Apelin-13 was significantly lower in the observation group(both P<0.05);compared with non-LVR group,the expression levels of preoperative serum miR-503 and LVEDD,IVST and LVPWT at 1 year after operation significantly increased in the LVR group,while the expression levels of preoperative Apelin-13 and LVEF at 1 year after operation sig⁃nificantly decreased(all P<0.05).There was a negative correlat

关 键 词：急性心肌梗死 左心室重构 微小RNA-503 孤独G蛋白偶联受体配体-13 老年人 

分 类 号：R542.2[医药卫生—心血管疾病]