血清miR-208a、miR-17-5p表达与急性心肌梗死患者左心室重构和预后的关系  

The relationship between the expression of miR-208a and miR-17-5p in serum and left ventricular remodeling and prognosis in patients with acute myocardial infarction

作　　者：张蕾[1] 贺建勋[1] 张琳琳[2] 翟光耀[2] 范雪松[1] 袁慧[1] Zhang Lei;He Jianxun;Zhang Linlin;Zhai Guangyao;Fan Xuesong;Yuan Hui(Clinical Laboratory,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;不详)

机构地区：[1]首都医科大学附属北京安贞医院检验科,100029 [2]首都医科大学附属北京安贞医院心脏内科冠心病中心,100029

出　　处：《疑难病杂志》2023年第3期247-252,265,共7页Chinese Journal of Difficult and Complicated Cases

基　　金：国家自然科学基金资助项目(81902155)。

摘　　要：目的 分析血清微小RNA-208a(miR-208a)、miR-17-5p表达与急性心肌梗死(AMI)患者左心室重构(LVR)和预后的关系。方法 选取2021年1—8月首都医科大学附属北京安贞医院心脏内科冠心病中心收治AMI患者133例,根据随访6个月时左心室收缩末期容积(LVESV)分为LVR组51例和非LVR组82例,并根据6个月时是否发生主要不良心血管事件分为预后不良组44例和预后良好组89例。采用qPCR检测患者血清miR-208a、miR-17-5p的表达水平,超声心动图检查左心室舒张末期内径(LVEDD)、舒张末期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室质量指数(LVMI)、LVESV。Spearman相关性分析LVR组患者血清miR-208a、miR-17-5p表达与确诊时LVESV的相关性,多因素Logistic回归分析AMI患者预后不良的影响因素,受试者工作特征曲线(ROC)分析血清miR-208a、miR-17-5p表达对AMI患者预后不良的预测价值。结果 LVR组血清miR-208a、miR-17-5p表达水平高于非LVR组(t/Z=7.432、10.964,P均<0.001);LVR组LVEDD、IVST、LVPWT、LVMI、LVESV高于非LVR组(t/Z=11.774、8.611、6.416、9.676、5.336,P均<0.001)。预后不良组血清miR-208a、miR-17-5p表达高于预后良好组(t/Z=5.270、5.376,P均<0.001)。Spearman相关性分析显示,LVR组血清miR-208a、miR-17-5p表达与确诊时LVESV呈正相关(r_(s)=0.868、0.735,P均<0.001)。多因素Logistic回归分析显示,年龄大、Killip分级≥Ⅲ级和血清miR-208a、miR-17-5p升高为AMI患者预后不良的独立危险因素[OR(95%CI)=1.058(1.005~1.114)、4.984(1.564~15.880)、1.051(1.007~1.097)、1.098(1.027~1.175)],LVEF升高为其独立保护因素[OR(95%CI)=0.932(0.892~0.975)]。ROC曲线分析显示,血清miR-208a、miR-17-5p及二者联合预测AMI患者预后不良的曲线下面积分别为0.781、0.795、0.866,二者联合预测的价值高于单项指标(Z/P=2.102/0.025、2.511/0.014)。结论 AMI患者血清miR-208a、miR-17-5p表达升高与LVR和预后不良相关,可作为AMI患者预后不良的辅Objective To analyze the relationship between the expression of microRNA-208a(miR-208a) and miR-17-5p in serum and left ventricular remodeling(LVR) and prognosis in patients with acute myocardial infarction(AMI). Methods 133 patients with AMI were selected from the Coronary Heart Disease Center of the Department of Cardiology, Beijing Anzhen Hospital affiliated to Capital Medical University from January to August 2021. According to the left ventricular end-systolic volume(LVESV) at the follow-up of 6 months, they were divided into LVR group(51 cases) and non-LVR group(82 cases), and were divided into poor prognosis group(44 cases) and good prognosis group(89 cases) according to whether major adverse cardiovascular events occurred at the time of 6 months. The expression levels of serum miR-208a and miR-17-5p were detected by qPCR. The left ventricular end-diastolic diameter(LVEDD), end-diastolic ventricular septal thickness(IVST), left ventricular posterior wall thickness(LVPWT), left ventricular mass index(LVMI) and LVESV were examined by echocardiography. Spearman correlation analysis was used to analyze the correlation between the expression of miR-208a and miR-17-5p in serum of patients with LVR and LVESV at the time of diagnosis, multivariate logistic regression analysis was used to analyze the factors affecting the poor prognosis of patients with AMI, and the working characteristic curve(ROC) of subjects was used to analyze the predictive value of the expression of miR-208a and miR-17-5p in serum on the poor prognosis of patients with AMI. Results The expression levels of serum miR-208a and miR-17-5p in LVR group were higher than those in non-LVR group(t/Z=7.432, 10.964,P<0.001). LVEDD, IVST, LVPWT, LVMI and LVESV in LVR group were higher than those in non-LVR group(t/Z=11.774, 8.611, 6.416, 9.676, 5.336,P<0.001). The expression of miR-208a and miR-17-5p in the poor prognosis group was higher than that in the good prognosis group(t/Z=5.270, 5.376,P<0.001). Spearman correlation analysis showed that the expres

关 键 词：心肌梗死 急性 微小RNA-208a 微小RNA-17-5p 左心室重构 预后 

分 类 号：R542.22[医药卫生—心血管疾病]