血清lncRNA-XIST和miR-23a在急性心肌梗死患者中的表达及临床意义

Expression and clinical significance of serum lncRNA-XIST and miR-23a in patients with acute myocardial infarction

目的研究急性心肌梗死(AMI)患者血清中lncRNA-XIST和miR-23a表达水平及临床意义。方法选取2020年1月至2021年6月到南充市中心医院心血管内科接受住院治疗的AMI患者78例(AMI组),另外选取同时期该院初诊为冠心病、稳定型心绞痛者80例作为对照组。静脉采血利用荧光定量PCR分析lncRNA-XIST和miR-23a相对表达水平,利用全自动生化仪检测胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯,ELISA分析肌酸激酶同工酶(CK-MB)和心肌肌钙蛋白I(cTnI)水平。Pearson分析AMI患者lncRNA-XIST和miR-23a与CK-MB和cTnI的相关性,绘制ROC曲线分析lncRNA-XIST、miR-23a及二者联合对AMI的诊断价值。结果与对照组比较,AMI组lncRNA-XIST和miR-23a相对表达水平明显上调(P<0.05)。lncRNA-XIST与CK-MB和cTnI水平呈正相关(r=0.710,P<0.001;r=0.771,P<0.001)、miR-23a相对表达水平与CK-MB和cTnI水平呈正相关(r=0.576,P<0.001;r=0.641,P<0.001,且lncRNA-XIST与miR-23a相对表达水平也呈正相关(r=0.707,P<0.001)。lncRNA-XIST和miR-23a单独预测AMI发生的AUC分别为0.828和0.816,二者联合预测AUC为0.947,lncRNA-XIST相对表达水平≥1.5,预测AMI的灵敏度为75.83%,特异度为80.52%;miR-23a相对表达水平≥1.5预测AMI的灵敏度为75.39%,特异度为81.11%,二者联合预测AMI的灵敏度为88.35%,特异度为86.52%。结论lncRNA-XIST、miR-23a在AMI患者血清中表达上调,二者联合检测对诊断AMI有一定参考价值。

Objective To investigate the expression levels and clinical significance of lncRNA-XIST and miR-23a in the serum of patients with acute myocardial infarction(AMI).Methods A total of 78 patients with AMI who came to Department of Cardiology,Nanchong Central Hospital for hospitalization from January 2020 to June 2021 were selected,and another 80 patients with coronary heart disease and stable angina in this hospital at the same time were selected as the control group.Venous blood samples were analyzed for lncRNA-XIST and miR-23a expression levels using qRT-PCR.The cholesterol,LDL-C,HDL-C,and triglycerides were detected using an automatic biochemical analyzer,and CK-MB and cTnI levels were detected by ELISA.The correlation between lncRNA-XIST and miR-23a and CK-MB and cTnI in AMI patients was analyzed by Pearson test,and the diagnostic value of lncRNA-XIST,miR-23a,and combined parameters for AMI was analyzed by ROC curves.Results Compared with the control group,the expression levels of lncRNA-XIST and miR-23a in serum were significantly up-regulated in the AMI group(P<0.05).LncRNA-XIST was positively correlated with CK-MB and cTnI(r=0.710,P<0.001;r=0.771,P<0.001),miR-23a was positively correlated with CK-MB and cTnI levels(r=0.576,P<0.001;r=0.641,P<0.001),and lncRNA-XIST was also positively correlated with miR-23a expression levels(r=0.707,P<0.001).The AUC of lncRNA-XIST and miR-23a alone in predicting the occurrence of AMI was 0.828 and 0.816,respectively,and the combined prediction AUC of the two was 0.947,the relative expression of lncRNA-XIST≥1.5.The prediction sensitivity of AMI was 75.83%,and the specificity was 80.52%.The sensitivity of miR-23a≥1.5 in predicting AMI was 75.39%,and the specificity was 81.11%,and the combined prediction sensitivity of AMI was 88.35%,and the specificity was 86.52%.Conclusion The expression of lncRNA-XIST and miR-23a is up-regulated in the serum of AMI patients,and the combined detection of lncRNA-XIST and miR-23a has some reference significance for the diagnosis of AMI.