急性ST段抬高型心肌梗死患者外周血miR-145-5p、miR-27b 3p浓度对经皮冠状动脉介入治疗后并发心力衰竭的预测价值  

Predictive Value of Peripheral Blood Concentrations of MicroRNA-145-5p and MicroRNA-27b-3p in Patients with Acute ST-Segment Elevation Myocardial Infarction for Postoperative Heart Failure after Percutaneous Coronary Inter⁃vention

作　　者：黄禄勇[1] 于力 唐明扬 HUANG Luyong;YU Li;TANG Mingyang(Department of Cardiology,The Fifth People′s Hospital of Chengdu,Chengdu 611130,China)

机构地区：[1]成都市第五人民医院心内科,都市611130

出　　处：《岭南心血管病杂志》2025年第1期1-6,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的探究急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者外周血微小核糖核酸(microRNA,miRNA)-145-5p、miR-27b-3p浓度对经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后并发心力衰竭(heart failure,HF)的预测价值。方法选择于2021年1月至2023年2月于成都市第五人民医院就诊的STEMI患者176例(均行PCI治疗)作为观察对象,观察STEMI患者PCI治疗后HF的发生情况,分为发生组和未发生组。实时定量聚合酶链反应(quantitative real time polymerase chain reaction,qRT-PCR)法检测外周血miR-145-5p、miR-27b-3p浓度。Pearson法、Spearman法分析血清miR-145-5p、miR-27b-3p及二者与一般资料的相关性。STEMI患者发生HF的影响因素采用多因素Logistic回归分析。绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清miR-145-5p、miR-27b-3p对STEMI患者PCI治疗后发生HF的预测价值。结果两组患者的病变支数、血清同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)浓度比较,差异有统计学意义(P<0.05)。发生组患者的血清miR-145-5p、miR-27b-3p浓度高于未发生组,差异有统计学意义(P<0.05)。根据Spearman相关性分析得知,血清miR-145-5p、miR-27b-3p浓度与病变支数呈正相关(P<0.05)。根据Pearson相关性分析得知,血清miR-145-5p浓度与miR-27b-3p浓度呈正相关(P<0.05);血清miR-145-5p、miR-27b-3p浓度与Hcy、hs-CRP浓度呈正相关(P<0.05)。多因素Logistic回归分析显示多支病变、Hcy、hs-CRP、miR-145-5p、miR-27b-3p为影响STEMI患者PCI治疗后发生HF的危险因素(P<0.05)。血清miR-145-5p预测STEMI患者PCI治疗后发生HF的曲线下面积(area under the curve,AUC)为0.896,血清miR-27b-3p预测STEMI患者PCI治疗后发生HF的AUC为0.883,二者联合预测STEMI患者发生HF的AUC为0.962,二者联合优于各自单独预测(P<0.05)。结论miR-145-5p、miR-27b-3p浓度升高与STEMI患者Objectives To explore the predictive value of peripheral blood concentrations of microRNA miR-145-5p and miR-27b-3p in patients with acute ST-segment elevation myocardial infarction(STEMI)for postoperative heart failure(HF)after percutaneous coronary intervention(PCI).Methods A total of 176 STEMI patients(all underwent PCI)diagonsed in The Fifth People′s Hospital of Chengdu from January 2021 to February 2023 were collected as the observation subjects.The incidence of postoperative HF in STEMI patients was observed.All the patients were separated into occurrence group and non occurrence group.Quantitative real time polymerase chain reaction(qRT-PCR)method was applied to detect the concentrations of miR-145-5p and miR-27b-3p in peripheral blood.Pearson′s method and Spearman′s method were applied to analyze serum concentrations of miR-145-5p,miR-27b-3p,and their correlation with general data.The influencing factors for HF in STEMI patients were analyzed using multivariate Logistic regression.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum concentrations of miR-145-5p and miR-27b-3p for postoperative HF in STEMI patients after PCI.Results The differences in the number of lesion branches,serum concentrations of homocysteine(Hcy)and hypersensitive C-reactive protein(hs-CRP)between the two groups were statistically significant(P<0.05).The serum concentrations of miR-145-5p and miR-27b-3p in occurrence group were higher than those in non occurrence group(P<0.05).According to Spearman correlation analysis,serum concentrations of miR-145-5p and miR-27b-3p were positively correlated with the number of lesions(P<0.05).According to Pearson correlation analysis,serum concentrations of miR-145-5p was positively correlated with miR 27b-3p(P<0.05).Serum concentrations of miR-145-5p and miR-27b-3p were positively correlated with serum concen⁃trations of Hcy and hs-CRP(P<0.05).Multivariate Logistic regression analysis indicated that Multiple vessel lesions,Hcy,hs-CRP,miR-145-

关 键 词：心肌梗死 微小核糖核酸-145-5p 微小核糖核酸-27b-3p 经皮冠状动脉介入治疗 心力衰竭 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]