血清miR-210、miR-378、miR-499水平与AMI患者术后左心功能和MACE发生情况的关系

Relationship between serum levels of miR-210,miR-378 and miR-499 with postoperative left ventricular function and MACE occurrence in patients with AMI

目的 研究血清微小核糖核酸(miR)-210、miR-378、miR-499水平与急性心肌梗死(AMI)患者术后左心功能和MACE发生情况的关系。方法 采取前瞻性研究,将2018年1月到2019年1月行PCI治疗的120例AMI患者作为研究对象,按照术后是否发生不良心血管事件(MACE)分为MACE组(n=29)和非MACE组(n=91),按是否发生左心室重构(LVR)分为LVR组(n=44)和非LVR组(n=76),比较MACE组与非MACE组、LVR组与非LVR组患者血清miR-210、miR-378、miR-499之间的差异,分析血清miR-210、miR-378、miR-499联合检测对MACE以及LVR的诊断效能。结果 MACE组术后miR-210、miR-378、miR-499水平均明显高于非MACE组(P<0.001)。LVR组的术后miR-210、miR-378、miR-499水平均明显高于非LVR组(P<0.001)。血清miR-210、miR-378、miR-499对MACE的诊断临界值分别为1.71、4.10、4.89,对LVR的诊断临界值分别为1.82、4.82、5.02。结论 联合检测血清miR-210、miR-378、miR-499水平对判断AMI患者术后左心功能和MACE发生具有指导意义,可为AMI的临床诊断以及预后评价提供科学依据。

Objective To study the relationship between the serum levels of miR-210,miR-378 and miR-499 with the postoperative left ventricular function and major adverse cardiovascular events(MACE)occurrence in the patients with acute myocardial infarction(AMI).Methods The prospective study was adopted.A total of 120 patients with AMI undergoing PCI from January 2018 to January 2019 served as the research subjects and divided into the MACE group(n=29)and non-MACE group(n=91)according to whether MACE occurred after operation.According to whether the left ventricle remodeling(LVR)occurred,they were divided into the LVR group(n=44)and non-LVR group(n=76).The differences of serum miR-210,miR-378 and miR-499 were compared between the MACE group and non-MACE group and between the LVR group and non-LVR group.The diagnostic efficiency of the combined detection of serum miR-210,miR-378 and miR-499 on MACE and LVR was analyzed.Results After operation,the levels of miR-210,miR-378 and miR-499 in the MACE group were significantly higher than those in the non-MACE group(P<0.001).The levels of miR-210,miR-378 and miR-499 in the LVR group were significantly higher than those in the non-LVR group(P<0.001).The area under the curve(AUC)of combined detection of serum miR-210,miR-378 and miR-499 for the diagnosis of MACE and LVR was significantly higher than that of each index single detection(P<0.01).The diagnostic critical values of serum miR-210,miR-378 and miR-499 for MACE were 1.71,4.10 and 4.89 respectively,and for LVR were 1.82,4.82 and 5.02 respectively.Conclusion The combined detection of serum miR-210,miR-378 and miR-499 levels has the significant guiding significance for judging the postoperative left heart function and MACE occurrence in the patients with AMI,and can provide a scientific basis for clinical diagnosis and prognostic evaluation of AMI.