基于血清ADAMTS13、miR-150、miR-375建立高龄急性心肌梗死患者术后生存状况预测模型的研究  

Establishment of a Predictive Model for Postoperative Survival in Elderly Patients with Acute Myocardial Infarction Based on Serum ADAMTS13, miR- 150 and miR- 375

作　　者：郑晓冬 苏亚坤 武晓玲 ZHENG Xiaodong;SU Yakun;WU Xiaoling(Department of Cardiovascular Medicine,Hengshui People's Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院心血管内科,河北衡水053000

出　　处：《中国分子心脏病学杂志》2024年第1期5893-5898,共6页Molecular Cardiology of China

摘　　要：目的 探讨血清血管性血友病因子裂解蛋白酶(von Willebrand factor lytic protease, ADAMTS13)、miR-150、miR-375预测高龄急性心肌梗死(acute myocardial infarction, AMI)患者术后生存状况价值。方法 选取2019年3月至2021年3月行经皮冠脉介入术(percutaneous coronary intervention, PCI)治疗的342例高龄AMI患者,根据术后12个月生存状况分为存活组和死亡组。比较两组一般资料、血清ADAMTS13、miR-150、miR-375水平,采用Cox回归方程分析高龄AMI患者术后生存状况影响因素,绘制列线图模型,采用校准曲线及受试者操作特征(receiver operating characteristic, ROC)曲线判断血清各指标、预测模型诊断效果,采用Kaplan-Meier曲线分析血清各指标不同表达生存状况。结果 死亡组血清ADAMTS13水平低于存活组,miR-150、miR-375水平及NYHA分级、冠状动脉病变支数所占比例高于存活组(P均<0.05)。ADAMTS13、miR-150、miR-375是高龄AMI患者术后生存状况影响因素(P均<0.05)。根据以上因素构建高龄AMI术后死亡风险列线图模型的C-index为0.865,其预测灵敏度及特异度分别为90.87%、62.86%。决策曲线发现,血清ADAMTS13、miR-150、miR-375联合预测模型优于单纯ADAMTS13、miR-150、miR-375预测结果。ADAMTS13高表达患者生存率高于低表达患者,miR-150、miR-375低表达患者生存率高于高表达患者(P均<0.05)。结论 基于血清ADAMTS13、miR-150、miR-375建立高龄AMI患者术后死亡预测模型具有良好预测效能,可指导临床医师确定合理治疗手段,降低死亡风险。Objective To investigate the value of serum ADAMTS13, miR-150 and miR-375 in predicting postoperative survival in elderly patients with acute myocardial infarction(AMI). Methods A total of 342 elderly patients with AMI in our hospital from March 2019 to March 2021 were selected, and all underwent percutaneous coronary intervention(PCI). General information, serum ADAMTS13, miR-150, miR-375 were recorded. COX regression equation were used to analyze the influencing factors of postoperative survival in elderly patients with AMI, and a nomogram model was drawn. Kaplan-Meier curves were used to analyze the survival status of different serum indexes. Results Serum ADAMTS13 levels were lower in the death group than in the survival group, and miR-150 and miR-375 levels and the proportion of NYHA classification and number of coronary artery lesions were higher than in the survival group(all P<0.05).ADAMTS13, miR-150 and miR-375 were the influencing factors of postoperative survival in elderly patients with AMI(all P<0.05).According to the above factors, the C-index of the mortality risk nomogram model after AMI was 0.865, and its predictive sensitivity and specificity were 90.87% and 62.86%, respectively. Decision curves found that the combined serum ADAMTS13, miR-150, miR-375 prediction model outperformed ADAMTS13, miR-150, miR-375 alone.The survival rate of patients with high ADAMTS13 expression was higher than that of patients with high ADAMTS13 expression. In patients with low expression, the survival rate of patients with low expression of miR-150 and miR-375 was higher than that of patients with high expression(all P<0.05). Conclusion Based on serum ADAMTS13, miR-150, and miR-375, the establishment of a postoperative mortality prediction model for elderly patients with AMI has good predictive performance, which can guide clinicians to determine reasonable treatment methods and reduce the risk of death.

关 键 词：高龄 急性心肌梗死 生存 ADAMTS13 miR-150 miR-375 

分 类 号：R542.22[医药卫生—心血管疾病]