MiRNA-483和miRNA-499在老年急性心肌梗死患者血浆中的表达及临床意义  

The expression of miRNA-483 and miRNA-499 in plasma of elderly patients with acute myocardial infarction and their clinical significance

作　　者：张和细 彭飞 费娟娟 龚辉 Zhang Hexi;Peng Fei;Fei Juanjuan;Gong Hui(Department of Cardiology,Jinshan Hospital,Fudan University,Shanghai,201508,P.R.China)

机构地区：[1]复旦大学附属金山医院心血管内科,上海201508

出　　处：《老年医学与保健》2024年第5期1285-1289,共5页Geriatrics & Health Care

基　　金：上海市卫生健康委员会项目(20214Y0367);上海市金山区卫生健康委员会项目(JSKJ-KTMS-2021-08)。

摘　　要：目的研究老年心肌肌钙蛋白Ⅰ(cTnI)升高患者血浆miRNA-483与miRNA-499鉴别急性心肌梗死(AMI)的诊断价值。方法2022年6月—2023年6月,纳入复旦大学附属金山医院cTnI升高的老年患者70例。年龄6093岁,平均(76.2±8.6)岁,其中男性34例、女性36例,心梗组36例、对照组34例。收集患者的一般资料,RT-qPCR检测血浆miRNA-483和miRNA-499。二元多因素Logistic回归明确AMI的危险因素,受试者操作特征(ROC)曲线分析miRNA-483和miRNA-499的曲线下面积(AUC)。结果与对照组相比,心梗组年龄较小,男性、吸烟者较多,血红蛋白、cTnI水平较高,氨基末端脑钠肽前体水平较低,miRNA-483和miRNA-499表达较高,差异有统计学意义(P<0.05)。二元Logistic回归显示,cTnI[OR(95%CI):2.251(1.3093.870)]、miRNA-483[OR(95%CI):4.399(1.27715.151)]和miRNA-499[OR(95%CI):5.487(1.41921.221)]水平升高与AMI呈正相关(P<0.05)。ROC曲线显示,血浆cTnI、miRNA-483、miRNA-499及miRNA-483联合miRNA-499预测AMI的AUC分别为0.832、0.882、0.834和0.914(P<0.05)。结论老年cTnI升高患者血浆miRNA-483和miRNA-499升高可能是AMI的危险因素。Objective To study the value of plasma miRNA-483 and miRNA-499 in the differential diagnosis of acute myocardial infarction(AMI)in elderly patients with elevated cardiac troponin I(cTnI).Methods From June 2022 to June 2023,70 elderly patients with elevated cTnI in Jinshan Hospital,Fudan University were collected.Their age ranged from 60 to 93 years old,with an average of(76.2±8.6)years.There were 34 males and 36 females,and 36 cases in the myocardial infarction group and 34 ones in the control group.Their general data were collected,and the levels of plasma miRNA-483 and miRNA-499 were detected by RT-qPCR.Binary multivariate Logistic regression was used to identify the risk factors for AMI,and receiver operating characteristic(ROC)curves were used to analyze the area under the curve(AUC)of miRNA-483 and miRNA-499.Results Compared with the control group,the myocardial infarction group had a younger age,higher proportion of males and smokers,higher levels of hemoglobin and cTnI,lower level of N-terminal pro brain natriuretic peptide,and higher expression of miRNA-483 and miRNA-499,with statistically significant differences(P<0.05).Binary Logistic regression showed that elevated levels of cTnI[OR(95%CI):2.251(1.309-3.870)],miRNA-483[OR(95%CI):4.399(1.277-15.151)],and miRNA-499[OR(95%CI):5.487(1.419-21.221)]were positively correlated with AMI(P<0.05).The ROC curve shows that the AUCs of plasma cTnI,miRNA-483,miRNA-499,and the combination of miRNA-483 and miRNA-499 in predicting AMI were 0.832,0.882,0.834 and 0.914,respectively(P<0.05).Conclusion Elevated plasma miRNA-483 and miRNA-499 may be risk factors for AMI in elderly patients with elevated cTnI.

关 键 词：老年 心肌肌钙蛋白 急性心肌梗死 鉴别诊断 

分 类 号：R542.22[医药卫生—心血管疾病]