血清miR-499及SOX6的表达与急性心肌梗死患者预后的关系及其预测价值

The relationship between the expression of serum miR-499 and SOX6 and the prognosis of patients with acute myocardial infarction and its predictive value

目的探讨血清miR-499及SOX6表达对急性心肌梗死(AMI)患者预后的评估价值。方法选取2016年2月2019年10月在石家庄人民医院心内科确诊的AMI患者132例,收集患者一般临床资料,采用实时荧光定量PCR(RT-qPCR)技术检测患者血清miR-499及SOX6的表达水平。根据患者随访期间是否发生主要不良心血管事件(MACE)分为非MACE组(n=87)和MACE组(n=45)。比较两组患者的临床数据,采用Logistic多因素回归分析发生MACE的独立危险因素和保护因素,通过受试者工作特征曲线(ROC)确定血清miR-499及SOX6表达水平的最佳截断点。结果与非MACE组比较,MACE组高血压比例显著升高(P<0.05),糖尿病比例显著升高(P<0.01);血清TG、hs-CRP及miR-499显著升高(P<0.05),血清NT-proBNP、cTnI显著升高(P<0.01),左室射血分数(LVEF)分数和血清SOX6相对表达显著降低(P<0.01)。多因素Logistic回归分析发现:高血压、糖尿病、hsCRP及血清miR-499表达为MACE发生的独立危险因素,LVEF和血清SOX6为MACE发生的保护因素。血清miR-499预测MACE的ROC曲线下面积为0.780,截断点为0.86,其灵敏度为78.25%,特异度为65.86%;血清SOX6预测MACE的ROC曲线下面积为0.721,截断点为0.75,其灵敏度为78.87%,特异度为62.58%。结论血清miR-499表达是AMI患者发生MACE的独立危险因素,血清SOX6表达是患者发生MACE的保护因素,对AMI患者预后具有较好的预测价值。

AIM To explore the evaluation value of serum miR-499 and SOX6 expression on the prognosis of patients with acute myocardial infarction(AMI). METHODS A total of 132 AMI patients diagnosed in the Department of Cardiology, Shijiazhuang People’s Hospital from February 2016 to October2019 were selected. The general clinical data of the patients were collected, and the biochemical parameters of blood lipid were detected. The expression levels of miR-499 and Sox6 in the serum of the patients were detected by real-time quantitative PCR(RT-qPCR). Patients were divided into the MACE group(n=45) and the non-MACE group(n=87) according to the occurrence of major adverse cardiovascular events(MACE) during the follow-up period, and the clinical data of the two groups were compared. Logistic multivariate regression was used to analyze the independent risk factors for MACE, and receiver operating characteristic curve(ROC) was used to determine the optimal cut-off point of serum miR-499 and Sox6 expression levels. RESULTS Compared with non-MACE group, the proportions of hypertension and diabetes in MACE group were significantly increased(P<0.05), the serum levels of TG,NT-proBNP, cTnI, hs-CRP and the relative expression of miR-499 were significantly increased(P<0.05),while the left ventricular ejection fraction(LVEF) fraction and the relative expression of serum Sox6 were significantly decreased(P<0.01). Multivariate Logistic regression analysis showed that hypertension, diabetes, hs-CRP and serum miR-499 expression were independent risk factors for the occurrence of MACE, while LVEF and serum SOX6 were protective factors for the occurrence of MACE.The area under the ROC curve of serum miR-499 for predicting MACE was 0.780 and the cut-off point was 0.86, with a sensitivity of 78.25% and specificity of 65.86%.The area under the ROC curve of serum SOX6 for predicting MACE was 0.721, the cutoff point was 0.75, the sensitivity was 78.87%, and the specificity was 62.58%. CONCLUSION Serum miR-499 and SOX6 are independent risk factors for the occurrence of MACE in AMI patients, and have a good predictive value for the prognosis of AMI patients.