CCTA联合血清miR-186-5p、miR-150-5p在冠心病中的诊断价值  

Diagnosis value of CCTA combined with serum miR-186-5p and miR-150-5p levels in coronary heart disease

作　　者：刘扬 宋彦丽 姚旭成 孙红红[1] 周建昌[1] 李金巍 程光辉 LIU Yang;SONG Yanli;YAO Xucheng;SUN Honghong;ZHOU Jianchang;LI Jinwei;CHENG Guanghui(Department of CT,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Clinical Laboratory,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Internal Medicine-Cardiovascular,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)

机构地区：[1]河北北方学院附属第二医院CT室,河北张家口075100 [2]河北北方学院附属第二医院检验科,河北张家口075100 [3]河北北方学院附属第二医院心内科,河北张家口075100

出　　处：《检验医学与临床》2025年第7期964-968,共5页Laboratory Medicine and Clinic

基　　金：河北省张家口市重点研发计划项目(2021120D)。

摘　　要：目的分析心脏冠状动脉血管成像(CCTA)联合血清miR-186-5p、miR-150-5p水平在冠心病(CHD)中的诊断价值。方法选取2021年12月至2023年12月该院收治的CHD患者135例为CHD组。选择同期体检的健康志愿者135例为对照组。采用Kappa一致性分析CCTA检测判定CHD与冠状动脉造影(CAG,“金标准”)的一致性;采用受试者工作特征(ROC)曲线分析血清miR-186-5p、miR-150-5p诊断CHD的cut-off值;采用四格表分析CCTA联合血清miR-186-5p、miR-150-5p对CHD的诊断价值;采用多因素Logistic回归分析CHD的影响因素。结果CCTA诊断CHD显示,阳性124例,检出率为45.93%(124/270);阴性146例,检出率为54.07%(146/270)。在135例CHD患者中,CCTA漏诊30例,漏诊率为22.22%(30/135);在135例健康志愿者中,CCTA误诊19例,误诊率为14.07%(19/135),与“金标准”诊断的一致性较高(Kappa=0.637,P<0.05)。与对照组比较,CHD组miR-186-5p水平升高,miR-150-5p水平降低,差异均有统计学意义(P<0.05)。miR-186-5p、miR-150-5p诊断CHD的cut-off值分别为1.190、0.759。CCTA联合血清miR-186-5p、miR-150-5p诊断CHD的准确度为82.96%,灵敏度为80.74%,高于CCTA、miR-186-5p、miR-150-5p单独诊断CHD的准确度和灵敏度(P<0.05)。多因素Logistic回归分析结果显示,miR-186-5p、miR-150-5p是CHD的影响因素(P<0.05)。结论在CHD患者中血清miR-186-5p水平升高,miR-150-5p水平降低,CCTA联合血清miR-186-5p、miR-150-5p诊断CHD的效能较好。Objective To explore the diagnosis value of coronary artery angiography(CCTA)combined with serum miR-186-5p and miR-150-5p levels in coronary heart disease(CHD).Methods A total of 135 CHD patients accepted in the Second Affiliated Hospital of Hebei North University from December 2021 to December 2023 were collected as the CHD group.A total of 135 healthy volunteers who underwent normal physical examinations were collected in the control group.Kappa consistency was applied to analyze the consistency between CCTA detection and CHD with the Coronary Angiography(CAG,"gold standard").The receiver operating characteristic(ROC)curve was used to analyze the cut-off values of serum miR-186-5p and miR-150-5p in the diagnosis of CHD.The diagnostic value of CCTA combined with serum miR-186-5p and miR-150-5p levels in CHD was analyzed by four-grid table.The factors affecting CHD were analyzed using multivariate Logistic regression analysis.Results The results of CCTA diagnosis for CHD showed that 124 cases were positive,with a detection rate of 45.93%(124/270),146 cases were negative,with a detection rate of 54.07%(146/270).Among 135 CHD patients,30 cases were misdiagnosed by CCTA,with a misdiagnosis rate of 22.22%(30/135),among 135 healthy volunteers,19 cases were misdiagnosed using CCTA,with a misdiagnosis rate of 14.07%(19/135),which was consistent with the"gold standard"diagnosis(Kappa=0.637,P<0.05).Compared with the control group,the expression level of miR-186-5p in the CHD group increased,while the expression level of miR-150-5p decreased,the differences were significant(P<0.05).The cut-off values of miR-186-5p and miR-150-5p in the diagnosis of CHD were 1.190 and 0.759 respectively.The accuracy of CCTA combined with serum miR-186-5p and miR-150-5p in the diagnosis of CHD was 82.96%,and the sensitivity was 80.74%,which were higher than those of CCTA,miR-186-5p and miR-150-5p alone(P<0.05).Multivariate Logistic analysis showed that miR-186-5p and miR-150-5p were the factors influencing CHD(P<0.05).Conclusion CHD patient

关 键 词：心脏冠状动脉血管成像 miR-186-5p miR-150-5p 冠心病 诊断 

分 类 号：R543.3[医药卫生—心血管疾病] R445.5[医药卫生—内科学]