| 马安枫,胡旭斌,蒋寅生.血清miR-500b-5p和miR-145-5p对急性心肌梗死患者预后的预测价值[J].浙江中西医结合杂志,2025,35(6): |
| 血清miR-500b-5p和miR-145-5p对急性心肌梗死患者预后的预测价值 |
| The expression of serum miR-500b-5p and miR-145-5p in patients with acute myocardial infarction and their relationship with prognosis |
| 投稿时间：2024-09-09 修订日期：2025-01-23 |
| DOI： |
| 中文关键词: 急性心肌梗死 微小核糖核酸-500b-5p 微小核糖核酸-145-5p 预后 |
| 英文关键词:Acute myocardial infarction Microribonucleic acid-500b-5p Microribonucleic acid-145-5p Prognosis |
| 基金项目:浙江省中医药科技计划项目(2023ZF036) |
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| 中文摘要: |
| 目的：检测急性心肌梗死患者血清微小核糖核酸(miR)-500b-5p和miR-145-5p表达水平,分析两者联合与急性心肌梗死患者预后之间的关系。方法：选取本院2020年4月-2022年4月收治的急性心肌梗死患者84例为研究组,根据随访记录分为预后良好组(n=54)和预后不良组(n=30),另选同期在本院治疗的不稳定心绞痛患者84例为对照组,采用qRT-PCR法检测血清miR-500b-5p和miR-145-5p相对表达量,收集分析一般临床资料,多因素Logistic回归分析急性心肌梗死患者预后的影响因素,绘制受试者工作特征(ROC)曲线分析血清miR-500b-5p和miR-145-5p对患者预后的预测价值,Pearson法分析血清miR-500b-5p、miR-145-5p与心脏相关指标的相关性。结果：与对照组相比,研究组血清miR-500b-5p相对表达量显著升高,miR-145-5p相对表达量显著降低(t=6.624,8.856,P＜0.05),预后不良组的N端前脑钠肽(NT-ProBNP)、肌钙蛋白(cTnI)、C反应蛋白(CRP)水平及miR-500b-5p相对表达量较预后良好组显著升高(t=12.080,11.186,9.265,8.170,P＜0.05),LVEF以及miR-145-5p相对表达量较预后良好组显著降低(t=3.311,7.100,P＜0.05)NT-ProBNP、miR-500b-5p均为影响患者预后不良的危险因素(OR=1.362,2.325,P＜0.05),miR-145-5p为影响患者预后不良的保护因素(OR=0.732,P＜0.05)；miR-500b-5p、miR-145-5p、NT-ProBNP、cTnI以及miR-500b-5p+miR-145-5p预测患者预后的AUC分别为0.772、0.832、0.809、0.799、0.917,miR-500b-5p+miR-145-5p联合预测的AUC显著优于miR-500b-5p(Z=2.953,P=0.003)、miR-145-5p(Z=2.246,P=0.025)、NT-ProBNP(Z=1.994,P=0.046)、cTnI(Z=2.095,P=0.036)单独预测；miR-500b-5p与NT-ProBNP、cTnI、CRP均呈正相关(r=0.485,0.462,0.424,P＜0.05),与LVEF呈负相关(r=-0.413,P＜0.05),miR-145-5p与NT-ProBNP、cTnI、CRP均呈负相关(r=-0.479,-0.456,-0.415,P＜0.05),与LVEF呈正相关(r=0.408,P＜0.05)。结论：急性心肌梗死预后不良患者的血清miR-500b-5p相对表达量升高,miR-145-5p相对表达量降低,二者联合对患者预后具有一定辅助预测价值。 |
| 英文摘要: |
| Objective: To detect the expression levels of serum microribonucleic acid (miR)-500b-5p and miR-145-5p in patients with acute myocardial infarction, and to analyze the relationship between the combination and the prognosis of patients with acute myocardial infarction. Methods: A total of 84 patients with acute myocardial infarction admitted to our hospital from April 2020 to April 2022 were included as the study group, and were separated into good prognosis group (n=54) and poor prognosis group (n=30) according to the follow-up records, and 80 healthy volunteers with physical examination during the same period were selected as the control group. QRT-PCR was used to detect the relative expression levels of serum miR-500b-5p and miR-145-5p. General clinical data were collected and analyzed. Multivariate logistic regression was used to analyze the influencing factors of prognosis in patients with acute myocardial infarction. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of serum miR-500b-5p and miR-145-5p for the prognosis of patients. Pearson method was used to analyze the correlation between serum miR-500b-5p and miR-145-5p with heart-related indicators. Results: Compared with the control group, the relative expression of miR-500b-5p in the study group was obviously increased, and the relative expression of miR-145-5p was obviously decreased (t=6.624, 8.856, P<0.05). The levels of N-terminal pro B type natriuretic peptide (NT-ProBNP), troponin (cTnI), C-reactive protein (CRP) and the relative expression of miR-500b-5p in the poor prognosis group were obviously higher than those in the good prognosis group (t=12.080, 11.186, 9.265, 8.170, P<0.05), and the LVEF and the relative expression of miR-145-5p were obviously lower than those in the good prognosis group (t=3.311, 7.100, P<0.05). NT-ProBNP and miR-500b-5p were risk factors for poor patient prognosis (OR=1.362, 2.325, P<0.05) and miR-145-5p was a protective factor for poor patient prognosis (OR=0.732, P<0.05). The AUC of miR-500b-5p, miR-145-5p, NT-ProBNP, cTnI, and the miR-500b-5p+miR-145-5p for predicting patient prognosis were 0.772, 0.832, 0.809, 0.799, and 0.917, respectively. The AUCs of the combination of miR-500b-5p+miR-145-5p were significantly better than those of miR-500b-5p 5p (Z=2.953, P=0.003), miR-145-5p (Z=2.246, P=0.025), NT-ProBNP (Z=1.994, P=0.046), and cTnI (Z=2.095, P=0.036) alone. MiR-500b-5p was positively correlated with NT-ProBNP, cTnI and CRP(r=0.485, 0.462, 0.424, P<0.05) and negatively correlated with LVEF (r=-0.413, P<0.05), and miR-145-5p was negatively correlated with NT-ProBNP, cTnI and CRP (r=-0.479, -0.456, -0.415, P<0.05) and positively correlated with LVEF (r=0.408, P<0.05). Conclusion: The relative expression level of serum miR-500b-5p is increased in patients with poor prognosis of acute myocardial infarction. The relative expression level of miR-145-5p is reduced. The combination of the two has certain auxiliary predictive value for prognosis. |
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