microRNA-499在急性ST抬高型心肌梗死诊断及预后评估中的价值

Value of MicroRNA-499 on the Diagnostic and Prognosis in Patients with ST-elevation Myocar-dial Infarction

【目的】研究外周血microRNA-499（miR-499）在急性ST抬高型心肌梗死（sTEMI）诊断及预后评估中的价值。【方法】选择2014年1月至2016年3月本院心血管内科及急诊内科收治的74例STEMI患者的临床资料（观察组），选择同期于本院体检的80例健康志愿者为对照组。所有受试者，入院即刻抽静脉血用于检测miR-499浓度。所有患者出院后均随访6个月，记录发生主要不良心血管事件（MACE）情况。比较两组患者miR-499浓度的差异性；通过Pearson相关性分析，研究miR-499与CK-MB及cTnI的线性关系，比较发生MACE的sTEMI患者与未发生MACE的患者miR-499浓度的差异。【结果】sTEMI患者外周血循环miR-499浓度较健康对照组患者明显增高（P〈0．01）。循环miR-499水平与肌钙蛋白I（cTnI）（r=0．475，P〈0．01）以及CK-MB（r=0．526，P〈0．01）呈正相关关系。31例sTEMI患者发生MACE归为MACE组，余下STEMI患者未发生归为非MACE组。通过分析发现，MACE组外周血循环miR-499浓度均显著高于非MACE组（P〈0．01）。【结论】外周血循环miR-499可以作为潜在的诊断STEMI以及评估其临床预后的指标。

[Objective]To detect the value of microRNA-499 on the diagnostic and prognosis in patients with ST-elevation myocardial infarction.[Methods]From January 2014 to March 2016, 74 STEMI patients ad- mitted to our hospital from January 2014 to March 2016 were selected as clinical data （observation group） and 80 healthy volunteers as control group. In all subjects, venous blood was taken immediately after admission for the detection of miR-499 concentrations. All patients were followed up for 6 months to record major adverse cardiovascular events （Mace）. By Persean correlation analysis, the linear relationship between miR-499 and CK-MB and cTnI was studied, and the difference of miR-499 concentration between STEMI patients with Mace and those without Mace was compared.[Results] The level of miR-499 in peripheral blood circulation in STEMI patients was significantly higher than that in healthy controls （ P〈0.01）. The level of circulating miR-499 was positively correlated with troponin I （cTnI） （ r =0.475, P 〈0.01） and CK-MB （ r = 0.526,P〈0.01）. 31 STEMI patients were classified as Mace group, while the remaining STEMI patients were not classified as non-MACE group. It was found that the concentration of miR-499 in peripheral blood circulation in Mace group was significantly higher than that in non-MACE group （ P〈0.01）. [Conclusion]Circulating miR-499 can be used as a potential marker for the diagnosis of STEMI and the evaluation of its clinical progno- sis.