机构地区:[1]西安交通大学第二附属医院,陕西西安710004
出 处:《中国药业》2023年第19期114-118,共5页China Pharmaceuticals
基 金:陕西省科技厅重点研发计划项目[2020SF-261]。
摘 要:目的 探讨急性心肌梗死患者血清葡萄糖调节蛋白78(GRP78)、热休克蛋白47(HSP47)、微小RNA-126(miR-126)表达与心功能的相关性。方法 选取医院2021年6月至2022年6月收治的急性心肌梗死患者80例为观察组,另选取同期健康体检者50例为对照组。采用酶联免疫吸附试验检测血清GRP78和HSP47水平及心肌肌钙蛋白I(cTnI)、肌酸激酶MB型同工酶(CK-MB)水平,采用实时荧光定量聚合酶链式反应(qRT-PCR)检测miR-126表达水平,采用超声心动图测定左心室射血分数(LVEF)。采用Pearson相关系数法进行相关性分析,根据全球急性冠状动脉事件注册研究(GRACE)评分将观察组患者分为高危组(12例)、中危组(31例)、低危组(37例),建立受试者操作特征(ROC)曲线,评价GRP78,HSP47,miR-126鉴别高危险分层的诊断价值。结果 观察组患者血清cTnI和CK-MB水平均显著高于对照组(P <0.05),LVEF显著低于对照组(P <0.05)。观察组患者血清GRP78和HSP47水平均显著高于对照组(P <0.05),且低危组、中危组、高危组呈持续上升趋势(P <0.05);miR-126相对表达显著低于对照组(P <0.05),且低危组、中危组、高危组呈持续下降趋势(P <0.05)。GRP78,HSP47与cTnI,CK-MB均呈正相关(P <0.05),与LVEF均呈负相关(P <0.05);miR-126与cTnI,CK-MB均呈负相关(P <0.05),与LVEF呈正相关(P <0.05)。GRP78诊断急性心肌梗死灵敏度为50.00%,特异度为98.50%;HSP47灵敏度为91.70%,特异度为64.70%;miR-126灵敏度为75.00%,特异度为89.70%;GRP78,HSP47,miR-126 3项联合预测的曲线下面积为0.928(P <0.05)。结论 急性心肌梗死患者血清GRP78和HSP47存在异常高表达,miR-126存在异常低表达,且3项指标与心功能有一定相关性,单独或联合分析时对临床鉴别患者的风险层级均有参考价值。Objective To investigate the correlation between the expression of serum glucose regulatory protein 78(GRP78),heat shock protein 47(HSP47),microRNA-126(miR-126) and cardiac function in patients with acute myocardial infarction.Methods A total of 80 patients with acute myocardial infarction admitted to the hospital from June 2021 to June 2022 were selected as the observation group,and 50 healthy subjects during the same period were selected as the control group.Enzyme-linked immunosorbent assay(ELISA) was used to detect serum levels of GRP78 and HSP47,and the levels of cardiac troponin I(cTnI) and creatine kinase isoenzyme MB type(CK-MB).Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR) was used to detect the expression level of miR-126,and echocardiography was used to measure left ventricular ejection fraction(LVEF).The Pearson correlation coefficient method was used for correlation analysis.Patients in the observation group were divided into high-risk group(12 cases),medium-risk group(31 cases),and low-risk group(37 cases) based on the Global Registry of Acute Coronary Events(GRACE) score.The receiver operating characteristic(ROC) curve was established and the diagnostic value of GRP78,HSP47,and miR-126 in distinguishing high-risk stratification was evaluated.Results The serum cTnI and CK-MB levels in the observation group were significantly higher than those in the control group(P<0.05),while the LVEF in the observation group was significantly lower than that in the control group(P<0.05).The levels of serum GRP78 and HSP47 in the observation group were significantly higher than those in the control group(P<0.05),and those in the low-risk,medium-risk,and high-risk groups showed a continuous upward trend(P<0.05).The relative expression of miR-126 in the observation group was significantly lower than that in the control group(P<0.05),and those in the low-risk,medium-risk,and high-risk groups showed a continuous downward trend(P<0.05).GRP78 and HSP47 were positively correlated with cTnI and CK-
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