RBP4、HbA1c与miR-1-3p在不同病情严重程度STEMI患者中的检测水平及诊断价值分析

Detection levels and diagnostic value of RBP4,HbA1c and miR-1-3p in STEMI patients with different disease severity

目的探讨视黄醇结合蛋白(RBP4)、糖化血红蛋白(HbA1c)与微小RNA(miR)-1-3p在不同病情严重程度ST段抬高型心肌梗死(STEMI)患者中的检测水平及诊断价值。方法选取2020年1月至2022年2月该院STEMI患者158例作为观察组,同期不稳定型心绞痛(UAP)患者79例作为对照Ⅰ组,体检健康者79例作为对照Ⅱ组。对比3组及观察组不同病情程度患者RBP4、HbA1c、miR-1-3p水平,分析上述指标与病情严重程度之间的关系,采用受试者工作特征(ROC)曲线分析RBP4、HbA1c、miR-1-3p对中、重度STEMI的诊断价值。结果观察组RBP4、HbA1c水平高于对照Ⅰ组、对照Ⅱ组,对照Ⅰ组RBP4、HbA1c水平高于对照Ⅱ组(P<0.05);观察组miR-1-3p相对表达水平低于对照Ⅰ组、对照Ⅱ组,对照Ⅰ组miR-1-3p相对表达水平低于对照Ⅱ组(P<0.05);RBP4、HbA1c水平与STEMI患者病情严重程度呈正相关(P<0.05),miR-1-3p与STEMI患者病情严重程度呈负相关(P<0.05);RBP4、HbA1c、miR-1-3p是STEMI患者病情严重程度的独立影响因素(P<0.05);RBP4、HbA1c、miR-1-3p联合诊断中、重度STEMI的曲线下面积大于单项指标(P<0.05)。结论RBP4、HbA1c、miR-1-3p与STEMI患者病情严重程度密切相关,三者联合检测能进一步提高病情严重程度鉴别效果。

Objective To investigate the detection levels and diagnostic value of retinol-binding protein(RBP4),glycosylated hemoglobin(HbA1c)and microRNA(miR)-1-3p in patients with ST-segment elevation myocardial infarction(STEMI)of different disease severity.Methods From January 2020 to February 2022,a total of 158 patients with STEMI in the hospital were selected as the observation group,79 patients with unstable angina pectoris(UAP)during the same period were selected as the control groupⅠ,and 79 healthy subjects were selected as the control groupⅡ.The levels of RBP4,HbA1c and miR-1-3p among the three groups and the observation group in patients with different disease severity were compared.The relationship between the above factors and the disease was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of RBP4,HbA1c and miR-1-3p for the moderate and severe STEMI.Results The levels of RBP4 and HbA1c in the observation group were higher than those in the control groupⅠand the control groupⅡ,and those in the control groupⅠwere higher than those in the control groupⅡ(P<0.05).The relative expression level of miR-1-3p in the observation group was lower than that in the control groupⅠand the control groupⅡ,and that in the control groupⅠwas lower than that in the control groupⅡ(P<0.05).The levels of RBP4 and HbA1c were positively correlated with the disease severity of STEMI patients(P<0.05),and miR-1-3p was negatively correlated with the disease severity of STEMI patients(P<0.05).RBP4,HbA1c,and miR-1-3p were the influencing factors of the disease severity of STEMI patients(P<0.05).The area under the curve of combined detection of RBP4,HbA1c and miR-1-3p in the diagnosis of moderate and severe STEMI was greater than that of a single index(P<0.05).Conclusion RBP4,HbA1c,miR-1-3p are closely related to the disease severity of STEMI patients,and the combination of the three could further improve the identification of the disease severity.