MiRNA-483和miRNA-499在老年急性心肌梗死患者血浆中的表达及临床意义

The expression of miRNA-483 and miRNA-499 in plasma of elderly patients with acute myocardial infarction and their clinical significance

中文关键词: 老年  心肌肌钙蛋白  急性心肌梗死  鉴别诊断

英文关键词: elderly  cardiac troponin  acute myocardial infarction  differential diagnosis

中文摘要:

      目的 研究老年心肌肌钙蛋白Ⅰ(cTnⅠ)升高患者血浆miRNA-483与miRNA-499鉴别急性心肌梗死(AMI)的诊断价值.方法 2022年6月-2023年6月,纳入复旦大学附属金山医院cTnⅠ升高的老年患者70例.年龄60～93岁,平均(76.2±8.6)岁,其中男性34例、女性36例,心梗组36例、对照组34例.收集患者的一般资料,RT-qPCR检测血浆miRNA-483和miRNA-499.二元多因素Logistic回归明确AMI的危险因素,受试者操作特征(ROC)曲线分析miRNA-483和miRNA-499的曲线下面积(AUC).结果 与对照组相比,心梗组年龄较小,男性、吸烟者较多,血红蛋白、cTnⅠ水平较高,氨基末端脑钠肽前体水平较低,miRNA-483和miRNA-499表达较高,差异有统计学意义(P＜0.05).二元Logistic 回归显示,cTnⅠ[OR(95％CI):2.251(1.309～3.870)]、miRNA-483[OR(95％CI):4.399(1.277～15.151)]和 miRNA499[OR(95％CI):5.487(1.419～21.221)]水平升高与 AMI 呈正相关(P＜0.05).ROC 曲线显示,血浆cTnⅠ、miRNA-483、miRNA-499 及 miRNA-483 联合 miRNA-499 预测 AMI 的 AUC 分别为 0.832、0.882、0.834 和 0.914(P＜0.05).结论 老年cTnⅠ升高患者血浆miRNA-483和miRNA-499升高可能是AMI的危险因素.

英文摘要:

      Objective To study the value of plasma miRNA-483 and miRNA-499 in the differential diagnosis of acute myocardial infarction(AMI)in elderly patients with elevated cardiac troponin Ⅰ(cTnⅠ).Methods From June 2022 to June 2023,70 elderly patients with elevated cTnⅠ in Jinshan Hospital,Fudan University were collected.Their age ranged from 60 to 93 years old,with an average of(76.2±8.6)years.There were 34 males and 36 females,and 36 cases in the myocardial in-farction group and 34 ones in the control group.Their general data were collected,and the levels of plasma miRNA-483 and miRNA-499 were detected by RT-qPCR.Binary multivariate Logistic regression was used to identify the risk factors for AMI,and receiver operating characteristic(ROC)curves were used to analyze the area under the curve(AUC)of miRNA-483 and miRNA-499.Results Compared with the control group,the myocardial infarction group had a younger age,higher proportion of males and smokers,higher levels of hemoglobin and cTnⅠ,lower level of N-terminal pro brain natriuretic peptide,and higher expression of miRNA-483 and miRNA-499,with statistically significant differences(P＜0.05).Binary Logistic regression showed that elevated levels of cTnⅠ[OR(95％CI):2.251(1.309-3.870)],miRNA-483[OR(95％CI):4.399(1.277-15.151)],and miRNA-499[OR(95％CI):5.487(1.419-21.221)]were positively correlated with AMI(P＜0.05).The ROC curve shows that the AUCs of plasma cTnⅠ,miRNA-483,miRNA-499,and the combination of miRNA-483 and miRNA-499 in predicting AMI were 0.832,0.882,0.834 and 0.914,respectively(P＜0.05).Conclusion Elevated plasma miR-NA-483 and miRNA-499 may be risk factors for AMI in elderly patients with elevated cTnⅠ.