血清微小RNA-199a-3p、E盒结合锌指蛋白1水平对急性冠状动脉综合征患者经皮冠状动脉介入术后预后的预测价值

Predictive value of serum microRNA-199a-3p and zinc finger E-box-binding protein 1 expression levels for the prognosis of patients with acute coronary syndrome after percutaneous coronary intervention

目的探讨微小RNA-199a-3p(miR-199a-3p)、E盒结合锌指蛋白1(ZEB1)对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后预后的预测价值。方法选取2021年5月至2022年5月秦皇岛市第二医院接收的行PCI术治疗的113例ACS患者为观察组,根据观察组患者PCI术后1年内是否发生主要不良心血管事件(MACE),分为MACE组26例和非MACE组87例,同期健康体检者106例为对照组。检测血清miR-199a-3p、ZEB1水平,比较MACE组和非MACE组临床资料,Pearson分析患者血清miR-199a-3p和ZEB1水平相关性,多因素Logistic分析影响ACS患者PCI术后发生MACE的影响因素,ROC曲线分析血清miR-199a-3p、ZEB1对ACS患者PCI术后发生MACE的预测价值。结果与对照组相比,观察组血清miR-199a-3p水平较低,ZEB1水平较高(t=13.709、25.641,P<0.05);在ACS患者中miR-199a-3p与ZEB1呈负相关(r=-0.421,P<0.05);ACS患者PCI术后较PCI术前血清miR-199a-3p水平高,ZEB1水平低(t=4.820、6.040,P<0.05);MACE组与非MACE组高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、左心室射血分数、miR-199a-3p、ZEB1比较,差异有统计学意义(t=3.310、2.717、3.947、7.068、6.544,P<0.05);LDL-C、ZEB1水平是ACS患者PCI术后MACE的危险因素,左心室射血分数、HDL-C、miR-199a-3p水平是ACS患者PCI术后MACE的保护因素;miR-199a-3p、ZEB1联合预测ACS患者PCI术后MACE的曲线下面积为0.947,优于单独预测(Z=1.970、2.791,P<0.05)。结论ACS患者血清中miR-199a-3p、ZEB1水平呈负相关,两者均对ACS患者PCI术后MACE有预测价值,两者联合的预测价值更高。

Objective To explore the predictive value of microRNA-199a-3p(miR-199a-3p)and zinc finger E-box-binding protein 1(ZEB1)for the prognosis of patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods From May 2021 and May 2022,113 ACS patients admitted to Qinhuangdao Second Hospital for PCI surgery were selected as the observation group.Based on the occurrence of major adverse cardiovascular events(MACE)within one year after PCI,they were grouped into the MACE group(26 cases)and the non-MACE group(87 cases).Additionally,106 healthy individuals undergoing physical examinations during the same period were selected as the control group.Serum miR-199a-3p and ZEB1 levels were detected.Clinical data were compared between the MACE and non-MACE groups.Pearson correlation analysis was used to examine the relationship between serum miR-199a-3p and ZEB1 levels in patients.Multivariate Logistic regression was performed to analyze factors influencing the occurrence of MACE in ACS patients after PCI.ROC curve analysis was conducted to evaluate the predictive value of serum miR-199a-3p and ZEB1 for MACE in ACS patients after PCI.Results Compared to the control group,serum miR-199a-3p level in the observation group decreased,while ZEB1 level increased(t=13.709,25.641;P<0.05).There was a negative correlation between miR-199a-3p and ZEB1 in ACS patients(r=-0.421,P<0.05).The level of miR-199a-3p in ACS patients after PCI was higher than that before PCI,and the level of ZEB1 was lower(t=4.820,6.040;P<0.05).Significant differences were found between the MACE group and non-MACE group in terms of high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),left ventricular ejection fraction(LVEF),miR-199a-3p,and ZEB1 levels(t=3.310,2.717,3.947,7.068,6.544;P<0.05).LDL-C and ZEB1 levels were risk factors for MACE in ACS patients after PCI,while LVEF,HDL-C,and miR-199a-3p levels were protective factors.The area under the curve(AUC)for the combined prediction of MACE using serum miR-199a-3p and ZEB1 was 0.947,which was superior to the prediction using either marker alone(Z=1.970,2.791;P<0.05).Conclusion Serum levels of miR-199a-3p and ZEB1 in ACS patients are negatively correlated,and both have predictive value for MACE in ACS patients after PCI.The predictive value of combination of miR-199a-3p and ZEB1 is higher than that of either marker alone.