血清miR-1及miR-499在老年急性心肌梗死患者中的表达及其与左室重构的关系

doi:10.3969/j.issn.1002-1949.2019.03.010

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摘要目的探讨血清microRNA-1(miR-1)及microRNA-499(miR-499)在老年急性心肌梗死（AMI）患者中的表达及其与左室重构（LVR）的关系。〖HTH〗方法〓〖HTSS〗选取2015年1月至2018年6月本院收治的182例老年AMI患者和65例体检健康者，根据AMI后是否发生LVR分为LVR组（n=56）和非LVR组（n=126）。检测两组血清miR-1、miR-499、心肌肌钙蛋白I（cTnI）及脑钠肽（BNP）水平，并进行比较。应用受试者工作特征曲线（ROC）分析血清miR-1、miR-499、cTnI及BNP水平对老年AMI患者发生LVR的预测价值。血清miR-1、miR-499、cTnI、BNP水平与左心室舒张末期容积（LVEDV）的相关性采用Pearson相关分析。结果 LVR组血清miR-1［（5.84±1.82) vs (3.18±1.17)vs. (0.950.36）］、miR-499［（4.30±1.35）vs.（2.38±0.91）vs.（0.62±0.25）］、cTnI［（4.18±1.63 )ng/mL vs.(2.52±1.20)ng/mL vs.(0.04±0.01)ng/mL］及BNP［（918.73±265.40)ng/L vs. (265.42±30.28)ng/L vs.(38.42±3.64）ng/L］水平均明显高于非LVR组和对照组（P<0.05）。血清miR-1和miR-499预测老年AMI患者发生LVR的曲线下面积（AUC）为0.895（95%CI0.831～0.962）和0.874（95%CI0.809～0.937），最佳截断值取4.36和3.15时，其敏感度和特异度分别为88.4%、85.0%和86.0%、82.7%。相关分析显示，LVR患者血清miR-1、miR-499、cTnI及BNP水平与LVEDV均呈正相关（r=0.847、0.805、0.704、0.862，P<0.01）。结论血清miR-1及miR-499高表达与LVR发生有关，有望作为预测老年AMI患者发生LVR的生物学标志物。

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	羊子伦
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关键词 ：急性心肌梗死(AMI), microRNA-1(miR-1), microRNA-499(miR-499), 左室重构(LVR)

基金资助:海南省医学科研基金资助(16A500230)

作者简介: 羊子伦（1979-），男，主治医师，E-mail：yzl897540493@163.com。

引用本文:

羊子伦，羊壮绵，郑伟民，吴晓东，陈运起. 血清miR-1及miR-499在老年急性心肌梗死患者中的表达及其与左室重构的关系[J]. 中国急救医学, 2019, 39(3): 248-253.
Yang Zi-lun, Yang Zhuang-mian, Zheng Wei-min, Wu Xiao-dong, Chen Yun-qi. Expression of serum miR-1 and miR-499 in elderly patients with acute myocardial infarction and their relationship with left ventricular remodeling. Chinese Journal of Critical Care Medicine, 2019, 39(3): 248-253.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.03.010 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I3/248

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