外周血miR-24水平与急性心肌梗死患者预后的相关性分析

Correlation Between Level of miR-24 in Peripheral Blood and Prognosis of Patients with Acute Myocardial Infarction

目的分析外周血miR-24水平与急性心肌梗死(AMI)患者预后的相关性分析。方法收集2017年5月—2018年5月入院就诊的AMI患者92例,根据临床诊断确定为急性ST段抬高型心肌梗死(STEMI)患者39例、急性非ST段抬高型心肌梗死(NSTEMI)患者53例,另选取非冠心病患者34例作为对照组;采用实时定量聚合酶链式反应(qRT-PCR)法检测患者外周血中miR-24水平,比较分析AMI患者miR-24水平与心功能指标的相关性;随访至2019年5月31日,分析AMI患者出院后主要不良心血管事件(MACE)发生与外周血miR-24水平的关系。结果STEMI组患者外周血miR-24水平显著低于NSTEMI组和对照组,高敏肌钙蛋白(hs-cTnT)、肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)水平显著高于NSTEMI组和对照组(P<0.05);Pearson相关分析显示,AMI患者外周血miR-24水平分别与hs-cTnT、CK-MB及CK水平呈负相关(均P<0.05);随访结果显示,AMI患者出院后有38例出现MACE,占比41.30%;MACE患者miR-24水平显著低于无MACE者(P<0.05);当外周血miR-24≤2.37时,预测患者出现MACE的曲线下面积为0.817,95%CI为0.722~0.890。结论外周血miR-24水平在AMI患者中异常降低,可作为预测患者预后的潜在血清标志物。

Objective To analyze correlation between level of miR-24 in peripheral blood and prognosis of patients with acute myocardial infarction(AMI).Methods A total of 92 AMI patients who were treated in the hospital during the period from May 2017 to May 2018 were collected.According to clinical diagnosis,it was confirmed that there were 39 cases with acute ST segment elevation myocardial infarction(STEMI)and 53 cases with acute non-ST segment elevation myocardial infarction(NSTEMI).34 patients with non-coronary heart disease were enrolled as control group.The level of miR-24 in peripheral blood was detected by quantitative real-time polymerase chain reaction(qRT-PCR).The levels of miR-24 in peripheral blood were compared among all groups.The correlation between miR-24 level and cardiac function indexes in AMI patients was analyzed.The follow-up lasted till May 31,2019.The relationship between occurrence of major adverse cardiovascular events(MACE)and level of miR-24 in peripheral blood after discharge in AMI patients was analyzed.Results The level of miR-24 in peripheral blood in STEMI group was significantly lower than that in NSTEMI group and control group,while levels of high-sensitivity troponin(hs-cTnT),creatine kinase(CK)and CK-isoenzyme(CK-MB)were significantly higher than those in NSTEMI group and control group(P<0.05).Pearson correlation analysis showed that miR-24 level was negatively correlated to levels of hs-cTnT,CK-MB and CK(P<0.05).Follow-up results showed that there were 38 AMI patients(41.30%)with MACE after discharge.The miR-24 level in MACE patients was significantly lower than that in patients without MACE(P<0.05).When miR-24 in peripheral blood was not higher than 2.37,area under ROC curve and 95%CI for predicting MACE were 0.817 and 0.722~0.890,respectively.Conclusion The level of miR-24 in peripheral blood is abnormally decreased in AMI patients,which can be applied as a potential serum marker to predict their prognosis.