急性心肌梗死病人外周血miR-499表达与病情及预后的关系  

Relationship between miR-499 expression in peripheral blood and disease and prognosis in patients with acute myocardial infarction

作　　者：王盛尧 陈宇[1] 王琼[1] WANG Shengyao;CHEN Yu;WANG Qiong(Department of Cardiovascular Medicine,Ziyang First People′s Hospital,Ziyang Sichuan 641300,China)

机构地区：[1]四川省资阳市第一人民医院心血管内科,641300

出　　处：《蚌埠医学院学报》2024年第5期615-618,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨急性心肌梗死(AMI)病人外周血miR-499表达对近期预后的预测价值。方法:选取AMI病人218例(AMI组),根据入院后90 d主要心血管不良事件发生与否,分为预后良好组178例和预后不良组40例;另选取同期健康体检志愿者100名作为对照组。比较各组外周血miR-499表达水平,采用ROC曲线分析外周血miR-499表达对AMI病人近期预后的预测价值,采用logistic回归模型分析AMI病人近期预后不良的危险因素。结果:AMI组病人外周血miR-499表达水平明显高于对照组(P<0.01),预后不良组病人外周血miR-499表达水平亦明显高于预后良好组(P<0.01)。ROC曲线分析显示,外周血miR-499表达水平预测AMI病人近期预后不良的最佳截断值为0.775,AUC为0.823(95%CI 0.753~0.892),灵敏度、特异度分别为71.11%、70.00%;logistic回归分析显示,术前Killip分级≥Ⅱ级、术前肌酸激酶同工酶峰值较高、外周血miR-499表达水平>0.775均为AMI病人近期预后不良的独立危险因素(P<0.05)。结论:AMI病人入院后早期外周血miR-499表达水平较高是近期预后不良的独立危险因素,且对病人不良预后具有早期预测价值。Objective:To investigate the predictive value of miR-499 expression in peripheral blood of patients with acute myocardial infarction(AMI)in short-term prognosis.Methods:A total of 218 AMI patients were divided into good prognosis group(n=178)and poor prognosis group(n=40)according to the occurrence of major cardiovascular adverse events 90 days after admission.A total of 100 healthy volunteers who received physical examination during the same period were used as control group.The miR-499 expression level in peripheral blood between good and poor prognosis group was compared.ROC curve was used to analyze the predictive value of miR-499 expression in peripheral blood for poor short-term prognosis in patients with AMI.Logistic regression model was used to analyze the risk factors for poor short-term prognosis in AMI patients.Results:The miR-499 expression level in peripheral blood of AMI patients was higher than that of control group(P<0.01),and expression of patients with poor prognosis group was higher than that of patients with good prognosis group(P<0.01).The results of ROC curve showed that the optimal cut-off value of miR-499 expression level in peripheral blood for predicting poor short-term prognosis of AMI patients was 0.775,AUC was 0.823(95%CI:0.753-0.892),corresponding sensitivity and specificity were 71.11%and 70.00%,respectively.Logistic regression analysis found that preoperative Killip grade≥Ⅱ,higher preoperative CK-MB peak,and the expression level of miR-499 in peripheral blood>0.775 were independent risk factors for poor short-term prognosis in AMI patients(P<0.05).Conclusions:High expression level of miR-499 in early peripheral blood of AMI patients after admission is an independent risk factor for poor prognosis,and has early predictive value for poor prognosis.

关 键 词：急性心肌梗死 miR-499 主要心血管不良事件 

分 类 号：R542.22[医药卫生—心血管疾病]