基于SYNTAX评分评价RBP4、miR-1-3p、VDBP与STEMI病情严重程度的相关性及对其的诊断价值

Correlation among RBP4,miR-1-3p,VDBP and disease severity in STEMI patients assessed by SYNTAX score and their diagnostic value for it

目的:基于SYNTAX评分分析人视黄醇结合蛋白4(RBP4)、miR-1-3p、重组人维生素D结合蛋白(VDBP)与ST段抬高型心肌梗死(STEMI)病情严重程度的相关性及对其的诊断价值。方法:选择2020年1月至2021年6月入住我院接受治疗的162例STEMI患者(STEMI组),另选取同期在我院接受体检的67例健康受试者作为健康对照组。根据SYNTAX评分,STEMI组被进一步分为低危组(68例,<22分)、中危组(53例,23分≤SYNTAX评分≤32分)和高危组(41例,>33分)。比较上述各组RBP4、VDBP水平和miR-1-3p表达水平,分析上述指标单独及联合检测对STEMI患者病情严重程度的诊断价值,分析STEMI患者SYNTAX评分与上述指标的相关性。结果:与健康对照组比较,STEMI组RBP4[(47.18±5.24)μg/L比(81.40±6.11)μg/L]、VDBP[(2.36±0.75)μg/ml比(3.55±1.04)μg/ml]水平显著升高,miR-1-3p表达[(1.18±0.13)比(0.72±0.07)]显著降低(P均<0.001)。与低危组比较,中危组和高危组的RBP4[(69.97±2.98)μg/L比(85.23±3.76)μg/L比(95.41±3.16)μg/L]、VDBP[(3.19±0.50)μg/ml比(3.55±0.52)μg/ml比(4.16±0.64)μg/ml]水平显著升高,miR-1-3p表达[(0.80±0.05)比(0.70±0.04)比(0.61±0.03)]显著降低,且高危组的RBP4和VDBP水平显著高于中危组,miR-1-3p表达显著低于中危组(P均<0.001)。ROC曲线分析显示上述指标联合检测的曲线下面积(AUC)为0.892,显著高于各单独检测(Z=4.787、3.078、2.495,P<0.05或<0.01)。Spearman相关分析显示,STEMI病情严重程度与RBP4、VDBP水平呈显著正相关(r=0.849、0.776,P均<0.001),与miR-1-3p呈显著负相关(r=-0.790,P<0.001)。结论:RBP4、VDBP水平及miR-1-3p表达水平能够反映STEMI患者的病情严重程度,三项联合检测对病情严重程度具有较高的诊断效能,可作为临床重要的观察指标来评估患者病情。

Objective:To analyze the correlation among human retinol binding protein 4(RBP4),miR-1-3p,recombinant human vitamin D binding protein(VDBP)and severity of ST-segment elevation myocardial infarction(STEMI)based on SYNTAX score and their diagnostic value for it.Methods:A total of 162 STEMI patients admitted to our hospital for treatment from January 2020 to June 2021 were selected as STEMI group,and another 67 healthy subjects who received physical examination in our hospital simultaneously were selected as healthy control group.According to SYNTAX score,STEMI group was further divided into low risk group(n=68,<22 points),medium risk group(n=53,23 points≤SYNTAX score≤32 points)and high risk group(n=41,>33 points).Levels of RBP4,VDBP and miR-1-3p expression were compared among above groups.Diagnostic value of single and combined detection of above indexes for severity of STEMI were analyzed.Correlation between SYNTAX score and above indexes were analyzed in STEMI patients.Results:Compared with healthy control group,there were significant rise in levels of RBP4[(47.18±5.24)μg/L vs.(81.40±6.11)μg/L]and VDBP[(2.36±0.75)μg/ml vs.(3.55±1.04)μg/ml],and significant reduction in miR-1-3p expression[(1.18±0.13)vs.(0.72±0.07)]in STEMI group,P<0.001 all.Compared with low risk group,there were significant rise in levels of RBP4[(69.97±2.98)μg/L vs.(85.23±3.76)μg/L vs.(95.41±3.16)μg/L]and VDBP[(3.19±0.50)μg/ml vs.(3.55±0.52)μg/ml vs.(4.16±0.64)μg/ml],and significant reduction in miR-1-3p expression[(0.80±0.05)vs.(0.70±0.04)vs.(0.61±0.03)]in medium risk group and high risk group,and levels of RBP4 and VDBP in high risk group were significantly higher than those of medium risk group,miR-1-3p expression in high risk group was significantly lower than that of medium risk group(P<0.001 all).ROC analysis indicated that area under the curve(AUC)of combined detection of above indexes was 0.892,which was significantly higher than each single detection(Z=4.787,3.078,2.495,P<0.05 or<0.01).Spearman correlation analysis indicated that STEMI severity was significant positively correlated with levels of RBP4 and VDBP(r=0.849,0.776,P<0.001 both),and significant inversely correlated with miR-1-3p expression(r=-0.790,P<0.001).Conclusion:Levels of RBP4 and VDBP,and miR-1-3p expression can reflect severity of STEMI patients.Triple combined detection possesses high diagnostic efficacy for disease severity,which can be used as clinical important indexes for assessing patient's condition.