miR-146b、cTnI、CK-MB、IL-10和IL-21在病毒性心肌炎患者血清中的表达及意义

Expression and significance of miR-146b,cTnI,CK-MB,IL-10 and IL-21 in serum of patients with viral myocarditis

目的探讨微小RNA-146b(micro RNA-146b,miR-146b)、心肌肌钙蛋白T(cTnI)、肌酸激酶同工酶MB(CK-MB)、白介素-10(IL-10)、白介素-21(IL-21)在病毒性心肌炎患者血清中的表达及意义。方法 50例急性期病毒性心肌炎患者(急性期组)、50例迁延期病毒性心肌炎患者(迁延期组)和50例慢性期毒性心肌炎患者(慢性期组)作为研究对象。选取同期进行健康体检的50例正常人为正常组。荧光定量RT-PCR技术检测miR-146b的表达,双抗体夹心法检测CK-MB、cTnI水平,酶联免疫吸附试验法检测IL-10、IL-21的血清水平。比较4组血清中miR-146b、IL-10、IL-21、cTnI和CK-MB水平变化情况,并进行相关性分析。结果 4组血清中miR-146b、IL-10、IL-21、cTnI和CK-MB的表达,两两比较差异均有统计学意义(P<0.05)。cTnI水平与miR-146b、IL-10、IL-21呈正相关(r值分别为0.927、0.925、0.931,P<0.05);CK-MB与miR-146b、IL-10、IL-21呈正相关(r值分别为0.931、0.917、0.924,P<0.05)。miR-146b、IL-10、IL-21三项指标联合检测的敏感度、特异度、准确度均显著高于任何两项联合检测和单项检测,差异均有统计学意义(P<0.05)。结论 miR-146b、cTnI、CK-MB、IL-10、IL-21在病毒性心肌炎患者血清中的水平均升高,miR-146b、IL-10、IL-21联合检测对病毒性心肌炎的诊断意义较大。

Objective To investigate the expression of micro-RNA-146 b(miR-146 b),cardiac troponin T(cTnI),creatine kinase MB form(CK-MB),interleukin-10(IL-10),and interleukin-21(IL-21)in the serum of patients with viral myocarditis.Methods A total of 50 patients with acute viral myocarditis who were treated in our hospital from June 2016 to June 2018 were enrolled as acute phase group,and 50 patients with delayed viral myocarditis were enrolled as lag phase group,moreover 50 patients with chronic toxic myocarditis were enrolled as chronic phase group.At the same time,50 healthy subjects who received physical examination in our hospital were enrolled as control group.The expression levels of miR-146 b were detected by fluorescence quantitative RT-PCR,and the levels of CK-MB and cTnI were detected by double antibody sandwich method,and the serum levels of IL-10 and IL-21 were detected by enzyme linked immunosorbent assay.Results There were significant differences in the expression levels of miR-146 b,IL-10 and IL-21 among the four groups each other(P<0.05).The expression levels of cTnI were positively correlated with those of miR-146 b,IL-10,IL-21(r=0.927, 0.925,0.931, respectively,P<0.05),and the the expression levels of CK-MB were positively correlated with those of miR-146 b,IL-10,IL-21(r=0.931,0.917,0.924,respectively,P<0.05),In addition the sensitivity,specificity and accuracy of combination detection of the three indexes(miR-146 b,IL-10 and IL-21) were significantly higher than those by any two indexes(P<0.05).Conclusion The levels of miR-146 b,cTnI,CK-MB,IL-10 and IL-21 are increased in the serum of patients with viral myocarditis.The combined detection of miR-146 b,IL-10 and IL-21 is of great significance in the diagnosis of viral myocarditis.