MicroRNA-590在急性心肌梗死诊断及预后评估中的价值

Value of microRNA-590 in diagnosis and prognosis of patients with acute myocardial infarction

目的研究microRNA-590(miR-590)在急性心肌梗死(AMI)诊断及预后评估中的价值。方法选择2018年5月至2019年10月安徽省第二人民医院心内科收治的患者162例,根据临床诊断及冠状动脉造影结果,分为对照组(HC组,n=40)、稳定型心绞痛(SAP)组(n=50)和AMI组(n=72),收集临床资料,运用定量逆转录聚合酶链反应检测各组血浆miR-590的表达水平,定期随访并记录患者出院后1年内主要不良心血管事件发生情况。结果AMI组患者血浆miR-590水平为(1.66±0.44)、cTnI水平为[5.17(1.20,16.85)]ng/mL、CK-MB水平为[45.00(35.25,68.00)]U/L,均高于SAP组和HC组,差异有统计学意义(P<0.05),SAP组和HC组血浆miR-590、cTnI及CK-MB水平差异均无统计学意义(P>0.05)。Spearman相关性分析显示,AMI患者血浆miR-590水平与cTnI(r=0.751,P<0.001)及CK-MB(r=0.692,P<0.001)均呈正相关。根据血浆miR-590水平中位数,将AMI组患者分为低miR-590组与高miR-590组,高miR-590组AMI患者1年内心力衰竭及主要不良心血管事件发生率高于低miR-590组(P=0.015)。结论血浆miR-590作为AMI诊断和预后评估的生物标志物具有重要的临床意义。

Objective To investigate the value of microRNA-590(miR-590)in the diagnosis and prognosis of patients with acute myocardial infarction(AMI).Methods A total of 162 patients admitted to the Department of Cardiology of Anhui No.2 Provincial People’s Hospital from May 2018 to October 2019 were divided into control group(HC,n=40),stable angina pectoris group(SAP,n=50)and acute myocardial infarction group(AMI,n=72)according to the results of clinical diagnosis and coronary angiography.The clinical data were collected and the expression level of miR-590 was detected by quantitative reverse transcriptase-polymerase chain reaction.All patients were followed up for main adverse cardiovascular events within one year after discharge.Results The plasma levels of miR-590(1.66±0.44),cTnI[5.17(1.20,16.85)]ng/mL and CK-MB[45.00(35.25,68.00)]U/L in AMI group patientswere higher than those in SAP group and HC group,andthe differences were statistically significant(P<0.05).There were no significant differences in plasma miR-590,cTnI and CK-MB levels between SAP group and HC group(P>0.05).Spearman correlation analysis showed that plasma miR-590 levels in AMI patients were positively correlated with cTnI(r=0.751,P<0.001)and CK-MB(r=0.692,P<0.001).The patients in AMI group were divided into low miR-590 group and high miR-590 group according to the median level of plasma miR-590,andthe incidence of heart failure and major adverse cardiovascular events in high miR-590 group was higher than that in low miR-590 group within one year(P=0.015).Conclusion Plasma miR-590 plays an important role as a biomarker both in diagnosis of AMI and in evaluation of its prognosis.