急性ST段抬高型心肌梗死患者血清miR-34a表达变化及临床意义

The change and clinical significance of serum miR-34a expression in patients with acute ST-segment elevation myocardial infarction

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者血清微小RNA-34a(miR-34a)的表达情况及其临床意义。方法:选择2018年5月~2022年5月本院诊治的83例STEMI患者(STEMI组),并选择同期83例体检健康者进行对照研究(健康组)。比较两组一般资料及血清miR-34a表达、肌酸激酶同工酶MB(CK-MB)、超氧化物歧化酶(SOD)水平;采用Pearson法分析STEMI患者血清miR-34a表达水平与CK-MB、SOD水平的相关性;采用Logistic回归分析STEMI发生的影响因素。结果:与健康组比较,STEMI组患者LDL-C[(2.18±0.73)mmol/L比(2.60±0.87)mmol/L]、TC[(3.82±0.75)mmol/L比(4.10±0.82)mmol/L]、TG[(1.38±0.35)mmol/L比(1.75±0.44)mmol/L]、miR-34a表达[(1.04±0.35)比(2.03±0.68)]、CK-MB[(18.12±8.27)U/L比(75.44±36.08)U/L]水平均显著升高(P<0.05或<0.01),血清SOD[(146.23±50.81)μU/L比(75.62±26.96)μU/L]水平显著降低(P<0.001)。Pearson相关分析显示STEMI患者血清miR-34a表达水平与CK-MB水平呈显著正相关(r=0.591,P<0.001),与SOD水平呈显著负相关(r=-0.588,P<0.001);Logistic回归分析显示LDL-C、miR-34a、TG是影响STEMI发生的独立危险因素(OR=2.768~66.754,P<0.05或<0.01),SOD是其独立保护因素(OR=0.955,P<0.001)。结论:STEMI患者血清miR-34a表达水平较高,与心肌损伤、氧化应激指标显著相关,miR-34a可能是诊治STEMI的潜在靶点。

Objective:To investigate the expression and clinical significance of serum microRNA-34a(miR-34a)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:A total of 83 STEMI patients diagnosed and treated in our hospital from May 2018 to May 2022 were selected as STEMI group,and 83 healthy subjects undergoing physical examination simultaneously were selected for a control study(healthy group).The general data and serum levels of miR-34a expression,creatine kinase isoenzyme MB(CK-MB)and superoxide dismutase(SOD)were compared between two groups;Pearson method was used to analyze the correlation among serum levels of CK-MB,SOD and miR-34a expression in STEMI patients;Logistic regression was used to analyze the influencing factors of STEMI.Results:Compared with healthy group,there were significant rise in levels of LDL-C[(2.18±0.73)mmol/L vs.(2.60±0.87)mmol/L],TC[(3.82±0.75)mmol/L vs.(4.10±0.82)mmol/L],TG[(1.38±0.35)mmol/L vs.(1.75±0.44)mmol/L],miR-34a expression[(1.04±0.35)vs.(2.03±0.68)]and CK-MB[(18.12±8.27)U/L vs.(75.44±36.08)U/L](P<0.05 or<0.01),and significant reduction in serum SOD level[(146.23±50.81)μU/L vs.(75.62±26.96)μU/L]in STEMI group(P<0.001).Pearson correlation analysis indicated that serum miR-34a expression level was significant positively correlated with CK-MB level(r=0.591,P<0.001),and significant inversely correlated with SOD level(r=-0.588,P<0.001)in STEMI patients.Logistic regression analysis indicated that LDL-C,miR-34a and TG were independent risk factors for STEMI(OR=2.768~66.754,P<0.05 or<0.01),while SOD was its independent protective factor(OR=0.955,P<0.001).Conclusion:The expression level of serum miR-34a is higher in STEMI patients,which is significantly related to myocardial injury and oxidative stress indicators.MiR-34a may be a potential target for the diagnosis and treatment of STEMI.