循环miRNA-26a-5p、miRNA-21-5p、miRNA-191-5p对老年急性心肌梗死患者的诊断价值

Diagnostic value of circulating miRNA-26a-5p,miRNA-21-5p and miRNA-191-5p in elderly patients with acute myocardial infarction

目的比较急性心肌梗死(AMI)患者和正常健康人中MicroRNAs(miRNAs)的表达,并评估循环miR-26a-5p、miR-21-5p和miR-191-5p对AMI的诊断价值。方法本研究是一项横断面研究,连续入选2020年5月至2020年12月于河南省人民医院老年医学科住院的老年AMI患者60例,另选取同期本院健康体检者60例为健康对照组(HCs)。使用qRT-PCR法检测60例老年AMI患者和60例HCs中循环miR-26a-5p、miR-21-5p、miR-191-5p的表达水平,使用ROC曲线分析血清miRNAs对AMI患者的诊断价值。结果老年AMI患者miRNAs的表达水平相较于HCs下降1.8~2.0倍。2-ΔCt表达水平:miR-26a-5p[(0.62±0.34)vs.(1.24±0.63),P<0.001]、miR-21-5p[(0.87±0.56)vs.(1.56±0.91),P<0.001]、miR-191-5p[(0.99±0.51)vs.(1.88±1.04),P<0.001]。MiR-26a-5p(AUC:0.806,95%CI:0.727~0.886,P<0.001)的诊断价值优于miR-21-5p(AUC:0.740,95%CI:0.651~0.828,P<0.001)和miR-191-5p(AUC:0.772,95%CI:0.689~0.855,P<0.001)。3个miRNA合并的曲线下面积为0.864(95%CI:0.929~0.799,P<0.001),敏感度为93.33%(95%CI:83.8%~98.2%),特异度为65.00%(95%CI:51.6%~76.9%)。结论MiR-26a-5p,miR-21-5p和miR-191-5p是有效的心肌梗死诊断生物标志物,可为AMI的诊断提供新思路。

Objective The purpose of this study was to compare the expressions of miRNAs in AMI patients and normal healthy people,and to review the diagnostic value of circulating miR-26a-5p,miR-21-5p and miR-191-5p to AMI.Methods Elderly AMI patients(n=60,AMI group)and healthy controls(n=80,control group)were chosen continuously from Department of Geriatrics in Henan Provincial People’s Hospital from May 2020 to Dec.2020.The expression levels of circulating miR-26a-5p,miR-21-5p and miR-191-5p were detected by using qRT-PCR in 2 groups.The diagnostic value of serum miRNAs in AMI patients was analyzed by using ROC curve.Results The expression levels of miRNAs were by 1.8 to 2.0 times fold lower in AMI group compared with control group 2-ΔCt expression level:miR-26a-5p[(0.62±0.34)vs.(1.24±0.63),P<0.001],miR-21-5p[(0.87±0.56)vs.(1.56±0.91),P<0.001]、miR-191-5p[(0.99±0.51)vs.(1.88±1.04),P<0.001].The diagnostic value of MiR-26a-5p(AUC:0.806,95%CI:0.727~0.886,P<0.001)was higher than that of miR-21-5p(AUC:0.740,95%CI:0.651~0.828,P<0.001)and miR-191-5p(AUC:0.772,95%CI:0.689~0.855,P<0.001).AUC of combined 3 miRNAs was 0.864(95%CI:0.929~0.799,P<0.001),sensitivity was 93.33%(95%CI:83.8%~98.2%)and specificity was 65.00%(95%CI:51.6%~76.9%).Conclusion MiR-26a-5p,miR-21-5p and miR-191-5p are effective biomarkers for diagnosing myocardial infarction,which can provide a new idea to AMI diagnosis.