血浆外泌体miR-204、miR-145水平用于急性心肌梗死早期诊断及预后评估价值探究  

Value of Plasma Exosomes MiR-204 and MiR-145 in the Early Diagnosis and Prognosis Evaluation of Acute Myocardial Infarction

作　　者：青一丹 杨晓瑜 QING Yidan;YANG Xiaoyu(Department of Cardiovascular Medicine,Affiliated Hospital of Sichuan Nursing Vocational College(the Third People's Hospital of Sichuan Province),Chengdu 610000,Sichuan,China)

机构地区：[1]四川护理职业学院附属医院(四川省第三人民医院)心血管内科,成都市610000

出　　处：《中国分子心脏病学杂志》2023年第4期5533-5539,共7页Molecular Cardiology of China

基　　金：四川省医学会科研课题(Q19040135)。

摘　　要：目的 探讨血浆外泌体microRNA-204(miR-204)、microRNA-145(miR-145)水平用于急性心肌梗死(acute myocardial infarction, AMI)的早期诊断及预后评估价值。方法 选取2019年5月至2021年10月收治经皮冠状动脉介入治疗(percutaneous coronary intervention PCI)的214例AMI患者作为AMI组,另选取同期健康体检人群200例作为对照组。检测AMI患者入院时以及对照组血浆外泌体miR-204、miR-145表达水平,观察AMI患者术后6个月内主要心血管不良事件(major adverse cardiovascular event,MACE)发生情况,对比MACE发生与未发生患者血浆外泌体miR-204、miR-145表达差异,通过logistic回归分析血浆外泌体miR-204、miR-145水平与患者预后的关系,通过受试者操作特征(receiver operating characteristic, ROC)曲线评估其对患者MACE发生的预测价值。结果 AMI组患者入院时血浆外泌体miR-204、miR-145表达水平低于对照组(P <0.05);血浆外泌体miR-204、miR-145水平联合检测评估AMI的发生ROC曲线下面积为0.853,显著高于两项指标单独评估曲线下面积0.787、0.779(P <0.05);214例AMI患者术后6个月内发生MACE者37例(17.29%),发生MACE患者入院时血浆外泌体miR-204、miR-145表达水平低于未发生MACE患者(P <0.05);入院时血浆外泌体miR-204、miR-145水平联合检测预测AMI患者术后6个月MACE发生ROC曲线下面积分别为0.785,显著高于两项指标单独评估曲线下面积0.646、0.668(P <0.05);logisitic回归分析显示高龄、合并高血压、糖尿病、高脂血症是AMI患者PCI术后MACE发生的独立危险因素,入院时血浆外泌体miR-204、miR-145高表达是预防AMI患者PCI术后MACE发生的保护因素。结论 AMI患者血浆外泌体miR-204、miR-405呈现低表达,二者表达水平可在一定程度上辅助临床AMI诊断,且其表达可反映患者的不良预后状态。Objective To explore the value of plasma exosomes microRNA-204(miR-204)and microRNA-145(miR-145)in the early diagnosis and prognosis evaluation of acute myocardial infarction(AMI).Methods A total of 214 patients with AMI undergoing percutaneous coronary intervention(PCI)in the hospital were enrolled as AMI group between May 2019 and October 2021,while 200 healthy controls during the same period were enrolled as control group.The expression levels of plasma exosomes miR-204 and miR-145 in AMI patients at admission and 7d after surgery,and in control group were detected.The occurrence of major adverse cardiovascular event(MACE)in AMI patients within 6 months after surgery was observed.The expression differences of plasma exosomes miR-204 and miR-145 in patients with and without MACE were compared,and their predictive value for MACE was evaluated by receiver operating characteristic(ROC)curves.Results At admission,expression levels of plasma exosomes miR-204 and miR-145 in AMI group were lower than those in control group(P<0.05).The area under ROC curve(AUC)of miR-204 combined with miR-145 for evaluating AMI was 0.853,significantly greater than that of single index(0.787,0.779,P<0.05).In the 214 AMI patients,there were 37 cases(17.29%)with MACE within 6 months after surgery.At admission,expression levels of plasma exosomes miR-204 and miR-145 in patients with MACE were lower than those without MACE(P<0.05).AUC of miR-204 combined with miR-145 at admission for predicting MACE was 0.785,significantly greater than that of single index(0.646,0.668,P<0.05).Logisitic regression analysis showed that advanced age,hypertension,diabetes mellitus and hyperlipidemia were independent risk factors of MACE in AMI patients after PCI,while high expressions of plasma exosomes miR-204 and miR-145 at admission were protective factors.Conclusion The expressions of plasma exosomes miR-204 and miR-405 are down-regulated in patients with AMI,which can assist the clinical diagnosis of AMI to a certain extent.Their expressions can reflect po

关 键 词：急性心肌梗死 生物标志物 外泌体 微RNA 

分 类 号：R542.22[医药卫生—心血管疾病]