循环microRNA-499与急性心肌梗死诊断的相关性

Relativity between plasma miR-499 and the early diagnosis in acute myocardial infarction

目的:分析血浆中microRNA-499(miR-499)与急性心肌梗死(AMI)诊断的相关性。方法:前瞻性连续性地招募2011-10-2014-03因胸痛而就诊于无锡市第二人医院急诊科及心血管科的患者进入本研究。在患者入院即刻即采集其血浆,以RT-PCR法检测miR-499表达。另从同期来医院体检的患者中募集105名个体作为对照。以受试者工作特征曲线法分析miR-499在胸痛人群中诊断AMI的准确性,采用Spearman法分析血浆miR-499与肌钙蛋白、肌酸激酶同工酶(CK-MB)之间的相关性。结果:AMI患者外周血miR-499较健康个体和非心肌梗死性胸痛患者明显增高。AMI患者血清miR-499在胸痛发作后持续增高,胸痛发生10h后仍然无下降趋势。血清miR-499诊断AMI的曲线下面积为0.68。miR-499与肌钙蛋白呈正相关,与CK-MB不相关。结论:血清miR-499是诊断AMI的有益标志物。

Objective：To detect the relativity between plasma miR-499 and the early diagnosis in acute myocardial infarction（AMI）.Method：The suspected AMI patients,who with chest pain and been admitted in the Second People＇s Hospital of Wuxi during Oct.2011 to Mar.2014,were consecutively and prospectively enrolled in the present study.The 105 healthy individuals were designed as healthy control.The plasma miR-499 was determined by real time polymerase chain reaction（RT-PCR）and the level of plasma CK-MB and cTnI were measured.Then,the receiver operating characteristic（ROC）curve was established to analyze the diagnostic accuracy of plasma miR-499 in AMI.Correlations between miR-499,CK-MB and cTnI were determined by the Spearman test.Result：The expression of plasma miR-499 was significantly increased in AMI patients compared with healthy controls and nonAMI chest pains（P〈0.05）.The contents of the plasma continuously elevated after symptom onset and did not fall down after 10 h.ROC curve analysis demonstrated that miR-499 had the specificity and sensitivity for the diagnosis of early AMI.Areas under the curve（AUCs）of miR-499 was 0.68.Plasma miR-499 correlated to cTnI,with correlation coefficients of 0.26（P=0.01）and did not relate to CK-MB.Conclusion：Plasma miR-499 has the capacity in early diagnosis of early AMI,and can be an useful biomarker for AMI.