循环miRNA检测在诊断急性冠脉综合征中的意义

Circulating miRNA detection in the diagnosis of acute coronary syndrome

目的:探讨循环miRNA检测在诊断急性冠脉综合征(ACS)中的意义。方法:选择100例ACS患者为研究组,匹配冠脉造影正常者100例为对照组,研究组再分为不稳定性心绞痛(UAP)组(n=32)和急性心肌梗死(AMI)组(n=68)。采用qRT-PCR方法检测血清miR-1,miR-133a,miR-208b,miR-499。结果:AMI患者的血清miR-1,miR-133a,miR-208b,miR-499水平较对照组显著增高,分别上调了4.15,4.46,7.95,6.62倍,UAP组较对照组也显著上升,分别上调了1.62,1.98,2.32,2.98倍,P均<0.05。4种miRNA在AMI患者中的变化曲线均表现为发病时显著升高,发病后6 h最高,发病后24 h,72 h显著下降,并接近正常水平。miR-1,miR-133a,miR-208b,miR-499对AMI患者诊断的ROC曲线下面积分别为0.68,0.75,0.80,0.73,介于肌酸激酶同工酶和肌钙蛋白T之间。结论:循环特异性miRNA的水平升高可用于辅助诊断ACS。

Objective： To investigate the circulating miRNA detection in the diagnosis of acute coronary syndrome. Methods： A total of 100 cases of ACS were collected for the study group, and 100 subjects of normal coronary angiography were matched for the control group. The study group was further divided into unstable angina （UAP） group （n = 32） and acute myocardial infarction （AMI） group （ n = 68 ）. qRT-PCR was used to detect serum miR-1, miR-133a, miR-208b, miR-499. Results： Serum miR-1, miR-133a, miR-208b, miR-499 levels in AMI patients were significantly higher than the control group. They were increased 4.15,4.46, 7.95,6.62 fold （median, the same below）. In UAP group, they were also increased significantly, 1.62, 1.98, 2.32, 2.98 fold compared with the control group respectively （P 〈 0.05）. Four kinds of miRNA in AMI patients showed a change curve that was significantly improved after the onset of incidence, highest in 6 h and after the onset of 24 h, 72 h, decreased significantly and closed to the normal level. The area under the ROC curve of miR-1, miR-133a, miR-208b, miR-499 in patients with AMI were 0. 68 ,0. 75 ,0. 80,0. 73 , higher than CK-MB but lower than cTnT. Conclusion： Elevated levels of specific circulating miRNA can be used for the diagnosis of ACS.