血清miR-499与急性冠脉综合征患者冠状动脉病变严重程度的相关性分析

Correlation analysis of serum miR-499 and severity of coronary lesions in patients with acute coronary syndrome

目的·探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血清中miR-499表达水平对冠状动脉病变严重程度的预测价值。方法·纳入就诊于上海交通大学医学院附属新华医院的ACS患者74例,根据Gensini评分将患者分为轻度组(30例)、中度组(21例)及重度组(23例)。荧光实时定量聚合酶链反应(real-time quantitative polymerase chain reaction,qPCR)技术检测血清miR-499的表达量,同时检测肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Mb)、脑钠肽(BNP)、左心室射血分数(LVEF)等实验室指标。采用Spearman相关分析评估miR-499表达水平与Gensini评分、冠状动脉病变血管支数的相关性。受试者操作特征(receiver operating characteristic,ROC)曲线分析miR-499对冠状动脉病变严重程度的评估价值。结果·miR-499的表达水平随着冠状动脉病变程度的加重呈上升趋势,组间差异有统计学意义(P=0.000)。miR-499表达水平与Gensini评分、cTnI水平呈正相关(r值分别为0.331、0.143,P<0.05),与LVEF无相关性(P>0.05);Gensini评分与cTnI、LVEF均无相关性(P>0.05)。ROC曲线分析结果显示,miR-499评估冠状动脉病变严重程度的AUC为0.802(95%CI 0.698~0.906),灵敏度为65.2%,特异度为80.4%。miR-499表达水平随着冠状动脉病变支数的增多呈升高趋势,且与冠状动脉病变支数呈正相关(r=0.368,P<0.05)。结论·ACS患者血清中miR-499表达水平与冠状动脉病变严重程度及病变支数相关,对冠状动脉病变严重程度具有一定评估价值。

Objective·To explore the value of miR-499 expression levels in the serum of patients with acute coronary syndrome(ACS)in predicting the severity of coronary artery disease.Methods·Seventy-four patients with ACS admitted to Xinhua Hospital,Shanghai Jiao Tong University School of Medicine were included and divided into a mild group of 30 cases,a moderate group of 21 cases,and a severe group of 23 cases according to the Gensini score.Real-time quantitative polymerase chain reaction(qPCR)technology was used to detect the expression level of serum miR-499,while troponin(cTnI),creatine kinase isoenzyme(CK-MB),myoglobin(Mb),brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),and other laboratory indicators were measured.Spearman correlation analysis was used to analyze the correlation between the expression level of miR-499 and Gensini score,as well as the number of vessel branches in coronary artery disease.The evaluation value of miR-499 in assessing the severity of coronary artery disease was analyzed by using receiver operating characteristic(ROC)curve.Results·The expression level of miR-499 increased with the severity of coronary artery disease(P=0.000).The expression level of miR-499 was positively correlated with Gensini score and cTnI(r=0.331,r=0.143,P<0.05),respectively,but not with LVEF(P>0.05),while Gensini score was not correlated with cTnI and LVEF(P>0.05).ROC analysis showed that the AUC of miR-499 for assessing the severity of coronary artery disease was 0.802(95%CI 0.698‒0.906),with sensitivity of 65.2%and specificity of 80.4%.The expression level of miR-499 increased with the increase of the number of coronary artery lesions,and was positively correlated with the number of coronary artery lesions(r=0.368,P<0.05).Conclusion·The expression level of miR-499 in the serum of ACS patients is correlated with the severity and number of coronary artery lesions,which has a certain evaluation value in evaluating the severity of coronary artery lesions.