CXCR4、miR-29a、GDF-15在急性心肌梗死中的表达及相关性研究

Expression and correlation of CXCR4,miR-29a and GDF-15 in acute myocardial infarction

目的 研究CXC趋化因子受体4(CXCR4)、微小核糖核酸-29a(miR-29a)、生长分化因子-15(GDF-15)在急性心肌梗死(AMI)中的表达及相关性。方法 选取2020年3月至2021年3月于合肥京东方医院就诊的58例AMI患者作为研究组,纳入同期因心前区不适前来就诊的50例非冠状动脉病变患者作为对照组,同期进行健康体检的45例健康志愿者作为健康组。采用酶联免疫吸附试验(ELISA)测定血清CXCR4、GDF-15表达水平,采用实时荧光定量PCR测定miR-29a表达水平。采用受试者工作特征(ROC)曲线分CXCR4、miR-29a、GDF-15对AMI的诊断价值,分析三者间的相关性。结果 与健康组相比,对照组、研究组CXCR4、miR-29a、GDF-15表达水平升高(P<0.05),与对照组相比,研究组CXCR4、miR-29a、GDF-15表达水平升高(P<0.05)。与单支病变相比,2支、3支病变患者CXCR4、miR-29a、GDF-15表达水平较高(P<0.05),与2支病变相比,3支病变患者CXCR4、miR-29a、GDF-15表达水平较高(P<0.05)。相关性分析发现,CXCR4、miR-29a之间呈正相关(r=0.670,P=0.001),miR-29a、GDF-15之间呈正相关(r=0.815,P=0.001),CXCR4、GDF-15之间呈正相关(r=0.700,P=0.001)。ROC曲线分析显示,与CXCR4、miR-29a、GDF-15单项诊断相比,3项联合诊断AMI的灵敏度更高、曲线下面积更大,诊断价值较高(P<0.05)。结论 CXCR4、miR-29a、GDF-15在AMI患者中呈高表达,且冠状动脉病变支数越多,CXCR4、miR-29a、GDF-15表达水平越高,三者间具有相关性,可能共同参与此病的发生、进展。

Objective To study the expression and correlation of CXC chemokine receptor-4(CXCR4),microribonucleic acid-29 a(miR-29 a) and growth differentiation factor-15(GDF-15) in acute myocardial infarction(AMI).Methods Fifty-eight patients with AMI treated in Hefei Jingdongfang Hospital from March 2020 to March 2021 were selected as the research group, and 50 patients with non-coronary artery lesion came to the clinic due to discomfort in the precordial area during the same period were included as the control group, and 45 healthy volunteers undergoing physical examination at the same period served as the healthy group.The expression levels of serum CXCR4 and GDF-15 were determined by enzyme-linked immunosorbent assay(ELISA),and the expression level of miR-29 a was determined by the real-time fluorescent quantitative PCR.The receiver operator characteristics(ROC) curve was used to analyze the diagnostic value of CXCR4,miR-29 a and GDF-15 in AMI.Then the correlation among the three was analyzed.Results Compared with the healthy group, the expression levels of CXCR4,miR-29 a and GDF-15 in the control group and study group were increased(P<0.05).Compared with the control group, the expression levels of CXCR4,miR-29 a and GDF-15 in the study group were increased(P<0.05).Compared with the patients with single branch lesion, the expression levels of CXCR4,miR-29 a and GDF-15 in the patients with 2 and 3 branches lesions were higher(P<0.05).Compared with the patients with 2 branches lesions, the expression levels of CXCR4,miR-29 a and GDF-15 in the patients with 3 branches lesions were higher(P<0.05).The correlation analysis showed that CXCR4 and miR-29 a were positively correlated(r=0.670,P=0.001);miR-29 a and GDF-15 were positively correlated(r=0.815,P=0.001);CXCR4 and GDF-15 were positively correlated(r=0.700,P=0.001).The ROC curve analysis showed that compared with the single diagnosis of CXCR4,miR-29 a and GDF-15,the combination diagnosis of the three had higher sensitivity, bigger AUC and higher diagnostic value for AMI(P<0.05).Conclusion CXCR4,miR-29 a and GDF-15 are highly expressed in AMI patients, and the more the coronary artery branch lesions, the higher the expression levels of CXCR4,miR-29 a and GDF-15.The three have the correlation and may participate in the occurrence and progression of this disease.