微小RNA-32-5p对老年急性心肌梗死有诊断价值

Diagnostic value of miR-32-5p in acute myocardial infarction in the elderly

目的:探究微小RNA-32-5p(miR-32-5p)对老年急性心肌梗死(AMI)的诊断价值。方法:纳入老年AMI患者107例为AMI组,选取同期收治的老年稳定性冠心病(SCHD)患者98例为SCHD组,选取同期体检的健康志愿者82例为对照组,检测并比较分析3组血清miR-32-5p表达及肌钙蛋白I(TnI)、肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)、白介素(IL)-1β、IL-6、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)-α水平。采用超声心动图检测3组左心室收缩末内径(LVESD)、左心室舒张末内径(LVEDD)、左室射血分数(LVEF)。对AMI组患者根据Gensini评分进行分组,分为<50分组和≥50分组,比较2组AMI患者的上述各指标,利用Pearson线性相关分析miR-32-5p与TnI、CK-MB、NT-proBNP、IL-1β、IL-6、TNF-α、hs-CRP、LVESD、LVEDD、LVEF的相关性,绘制受试者工作特征(ROC)曲线,分析miR-32-5p诊断老年AMI的曲线下面积(AUC)。结果:AMI组血清miR-32-5p表达及TnI、CK-MB、NT-proBNP、LVESD、LVEDD、IL-1β、IL-6、TNF-α、hs-CRP水平高于SCHD组和对照组,且SCHD组高于对照组;LVEF低于SCHD组和对照组(P均<0.05)。Gensini评分≥50分组血清miR-32-5p及TnI、CK-MB、NT-proBNP、LVESD、LVEDD、IL-1β、IL-6、TNF-α、hs-CRP水平高于Gensini评分<50分组,LVEF低于Gensini评分<50分组(P均<0.05)。Pearson线性相关分析显示血清miR-32-5p表达与TnI、CK-MB、NT-proBNP、LVESD、LVEDD、IL-1β、IL-6、TNF-α、hs-CRP水平呈正相关,与LVEF呈负相关(P均<0.05)。血清miR-32-5p诊断AMI的AUC为0.788(P=0.000,95CI%:0.721~0.855)。结论:老年AMI患者的血清miR-32-5p表达上调,对AMI的诊断有一定价值。

Objective:To study the diagnostic value of microRNA-32-5p(miR-32-5p)in elderly acute myocardial infarction(AMI).Methods:A total of 107 elderly patients with AMI were included in the AMI group,98 elderly patients with stable coronary heart disease(SCHD)admitted to the same period were selected as the SCHD group,and 82 healthy volunteers who received physical examination during the same period were selected as the control group.The serum levels of miR-32-5p,TnI,CK-MB,NT-proBNP,IL-1β,IL-6,high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)were compared among the three group.Left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by echocardiography.The above indexes of AMI patients with different Gensini scores(<50 subgroup and≥50 subgroup)were compared.Pearson linear correlation was used to analyze the correlation between miR-32-5p and the rest indicators.The area under the curve(AUC)of miR-32-5p in the diagnosis of elderly AMI was analyzed by drawing receiver operating characteristic(ROC)curve.Results:Serum miR-32-5p expression and TnI,CK-MB,NT-proBNP,LVESD,LVEDD,IL-1β,IL-6,TNF-α,hs-CRP levels in the AMI group were higher than those in the SCHD group and the control group.LVEF in the AMI group was lower than that in the SCHD group and control group(P<0.05).Serum miR-32-5p expression and TnI,CK-MB,NT-proBNP,LVESD,LVEDD,IL-1β,IL-6,TNF-α,hs-CRP levels in the Gensini score≥50 subgroup were higher than those in the<50 subgroup.LVEF was lower in the Gensini score≥50 subgroup than that in the<50 subgroup(P<0.05).Pearson linear correlation analysis showed that serum miR-32-5p expression was positively correlated with TnI,CK-MB,NT-proBNP,LVESD,LVEDD,IL-1β,IL-6,TNF-α,hs-CRP levels,and negatively correlated with LVEF(P<0.05).The AUC of serum miR-32-5p expression in the diagnosis of AMI was 0.788(P=0.000,95CI%:0.721-0.855).Conclusion:The expression of serum miR-32-5p is up-regulated in elderly patients with AMI,and it is of certain value in the diagnosis of AMI.