外周血cTnT、Hcy及miRNA-92表达水平对急性冠状动脉综合征患者病情严重程度及短期预后的诊断价值  

Diagnostic Value of the Expressions of CTnT,Hcy and MicroRNA-92 in Periph⁃eral Blood on The Severity and Short-Term Prognosis of Patients with Acute Coronary Syndromes

作　　者：许敏[1] 钟奇超 张询[1] 苟成 刘丁铭 XU Min;ZHONG Qichao;ZHANG Xun;GOU Cheng;LIU Dingming(Department of Cardiology,People′s Hospital of Guang′an,Guang′an,Sichuan 638000,China)

机构地区：[1]广安市人民医院心血管内科,四川广安638000

出　　处：《岭南心血管病杂志》2023年第2期136-143,共8页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨外周血心肌肌钙蛋白T(cardiac troponin T,cTnT)和同型半胱氨酸(homocysteine,Hcy)及微小RNA(microRNA,miRNA)-92表达水平对急性冠状动脉综合征(acute coronary syndromes,ACS)患者病情严重程度及短期预后的诊断价值。方法选取广安市人民医院心血管科于2020年1月至2021年1月收治的206例ACS患者作为研究对象。分析外周血c TnT、Hcy及miRNA-92表达水平与Gensini评分的相关性,并对患者治疗后30 d进行随访,观察再次发生主要不良心血管事件(major adverse cardiac events,MACE)情况,建立ACS患者30 d MACE的预测模型,并对模型的诊断效能进行分析。结果206例患者中急性心肌梗死(acute myocardial infarction,AMI)患者135例(65.5%),不稳定型心绞痛(unstable angina,UA)患者71例(34.5%),冠状动脉单支病变25例(12.1%),双支病变62例(30.1%),多支病变119例(57.8%)。与UA组患者比较,AMI组患者外周血cTnT、Hcy和miRNA-92表达水平明显升高,差异具有统计学意义(P<0.05)。而不同冠状动脉病变支数组患者间上述指标比较,差异无统计学意义(P>0.05)。多元线性回归分析提示,外周血c TnT、Hcy和miRNA-92表达水平与Gensini评分呈正相关,回归方程为Y_(Gensini)=27.269+1.870×X_(miRNA)-92+1.595×X_(cTnT)+0.827×X_(Hcy)。不同预后患者二元Logistic回归分析提示,外周血c TnT、Hcy和miRNA-92表达水平升高是ACS患者30 d内并发MACE的独立危险因素,联合上述3个指标预测MACE发生的AUC较单个指标显著提升,结果具有统计学意义(P<0.01)。结论外周血cTnT、Hcy和miRNA-92表达水平与ACS患者病情严重程度密切相关,且联合上述3个指标可显著提升对ACS患者短期预后的预测价值。Objectives To explore the diagnostic value of the expressions of cardiac troponin T(cTnT),homocysteine(Hcy)and microRNA(miRNA)-92 in peripheral blood on the severity and short-term prognosis of patients with acute coronary syndromes(ACS).Methods A total of 206 ACS patients admitted to the Department of Cardiology of People′s Hospital of Guang′an from January 2020 to January 2021 were selected as the research objects.The correlations between the expressions of cTnT,Hcy and miRNA-92 in peripheral blood and Gensini score were analyzed in these patients.The patients were followed up for 30 days after treatment to observe the recurrence of major adverse cardiac events(MACE).The predictive model of 30 d MACE for ACS patients was established,and the diagnostic efficiency of the model was analyzed.Results Among the 206 patients,135(65.5%)of them were acute myocardial infarction(AMI)patients,71(34.5%)of them were unstable angina(UA)patients,25(12.1%)of them were single-vessel coronary artery disease patients and 62(30.1%)of them were double-vessel disease patients,119(57.8%)of them were multivessel disease patients.Compared with UA group,the expressions of cTnT,Hcy and miRNA-92 in the peripheral blood of AMI group were significantly increased,and the differences were statistically significant(P<0.05).However,there were no statisti⁃cally significant differences in the above indicators among different coronary artery diseased branches(P>0.05).Multiple linear regression analysis showed that the expressions of cTnT,Hcy and miRNA-92 in the peripheral blood positively correlated with Gensini score.The regression equation was Y_(Gensini)=27.269+1.870×X_(miRNA-92)+1.595×X_(cTnT)+0.827×X_(Hcy).The binary Logistic regression analysis of patients with different prognosis indicated that the increased expressions of cTnT,Hcy and miRNA-92 in the peripheral blood were independent risk factors for MACE in ACS patients within 30 days.The combination of the above three indicators predicted that the AUC of MACE was significantly hi

关 键 词：冠状动脉疾病 心肌肌钙蛋白T 同型半胱氨酸 微小RNA-92 严重程度 

分 类 号：R541.4[医药卫生—心血管疾病]