miR-133a和miR-208a对急性冠脉综合征患者PCI术后心肌损伤的诊断价值

Diagnostic Values of MiR-133a and MiR-208a in Myocardial Injury after PCI in Patients with Acute Coronary Syndrome

目的:分析miR-133a和miR-208a对急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后心肌损伤的诊断价值。方法:将2017年6月至2019年1月在邯郸市第一医院行PCI术治疗的83例ACS患者,并根据PCI术后心肌损伤情况分为心肌损伤组41例和非心肌损伤组42例。采用实时荧光定量PCR(RT-PCR)检测患者血清miR-133a和miR-208a表达水平,采用化学发光免疫分析法检测血清肌钙蛋白I(cTnI)水平,Pearson相关法分析患者血清miR-133a和miR-208a表达水平与cTnI水平的相关性,采用受试者工作特征曲线(ROC)评估miR-133a和miR-208a对患者PCI术后心肌损伤的诊断价值。结果:心肌损伤组血清中cTnI水平和miR-133a、miR-208a相对表达量均明显高于非心肌损伤组(P<0.05);患者血清中miR-133a、miR-208a相对表达量分别与cTnI水平呈正相关关系(r=0.741、0.770,P<0.001);miR-133a、miR-208a诊断ACS患者PCI术后心肌损伤的ROC曲线下面积(AUC)分别为0.809(95%CI0.825~0.961)、0.853(95%CI0.890~0.990),其诊断临界值分别为0.95、0.31,敏感性分别为93.60%、95.12%,特异性分别为73.80%、83.33%。结论:miR-133a、miR-208a对ACS患者PCI术后心肌损伤具有较好的诊断敏感性和特异性,是ACS患者PCI术后心肌损伤的有效生物标志物。

Objective:To analyze the diagnostic values of miR-133a and miR-208a in myocardial injury after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods:83 patients with ACS who underwent PCI in Handan First Hospital from June 2017 to January 2019 were divided into 41 patients with myocardial injury group and 42 patients with non-myocardial injury group according to the myocardial injury after PCI.Real-time fluorescence quantitative polymerase chain reaction(RT-PCR)was used to detect the levels of serum miR-133a and miR-208a,serum troponin I(cTnI)levels were measured by chemiluminescence immunoassay,Pearson correlation method was used to analyze the correlations between levels of serum miR-133a and miR-208a with cTnI,subject operating characteristic curve(ROC)was used to evaluate the diagnostic value of miR-133a and miR-208a in patients with myocardial injury after PCI.Results:The levels of serum cTnI and the relative expressions of miR-133a and miR-208a in myocardial injury group were significantly higher than those in non-myocardial injury group(P<0.05);the relative expressions of miR-133a and miR-208a in serum of patients were positively correlated with the level of cTnI(r=0.741,0.770,P<0.001);the areas under ROC curve(AUC)of miR-133a and miR-208a in diagnosing myocardial injury after PCI in ACS patients were 0.809(95%CI was 0.825-0.961)and 0.853(95%CI was 0.890-0.990),respectively,the diagnostic thresholds were 0.95 and 0.31,the sensitivity was 93.60%and 95.12%,the specificity was 73.80%and 83.33%,respectively.Conclusion:MiR-133a and miR-208a have good diagnostic sensitivities and specificities for myocardial injury after PCI in ACS patients.They are effective biomarkers of myocardial injury in ACS patients after PCI.