急性心肌梗死患者血清lncRNA p21表达水平及临床意义

目的 探究急性心肌梗死(AMI)患者血清lncRNA p21表达水平及临床意义。方法 选取河南科技大学第一附属医院心外科2019年1月至2021年1月收治的92例AMI患者(AMI组),根据冠脉病变程度分为轻度病变组(n=29)、中度病变组(n=43)和重度病变组(n=20);同期选择本院体检健康者92例为对照组。AMI患者在经皮冠状动脉植入术(PCI)术后随访24个月,将患者分为心血管不良事件(MACE)组(n=22)和非MACE组(n=70)。采用实时荧光定量聚合酶链式反应检测研究对象血清中lncRNA p21表达水平。采用Pearson法分析AMI患者血清lncRNA p21水平与肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平的相关性。采用受试者工作特征(ROC)曲线评价血清lncRNA p21水平预测AMI的价值。结果 与对照组相比,AMI组血清lncRNA p21相对表达水平较低(P＜0.05),CK-MB及cTnI水平较高(P＜0.05)。与轻度病变组相比,中度病变组、重度病变组血清lncRNA p21相对表达水平较低(P＜0.05),CK-MB、cTnI水平较高(P＜0.05);与中度病变组相比,重度病变组血清lncRNA p21相对表达水平较低(P＜0.05),CK-MB、cTnI水平较高(P＜0.05)。AMI患者血清lncRNA p21水平与cTnI、CK-MB水平均呈负相关(P＜0.05)。ROC曲线显示,lncRNA p21水平预测AMI的曲线下面积(AUC)为0.861,其灵敏度、特异度分别为70.70%、89.10%;lncRNA p21联合cTnI、CK-MB预测AMI的AUC为0.956,其灵敏度、特异度分别为89.10%、94.60%。与非MACE组相比,MACE组治疗前血清lncRNA p21相对表达水平较低(P＜0.05)。结论 AMI患者血清lncRNA p21表达水平下降,lncRNA p21对AMI具有一定的诊断价值。

Serum lncRNA p21 expression level and clinical significance of patients with acute myocardial infarction

Objective To explore the expression level and clinical significance of serum lncRNA p21 in patients with acute myocardial infarction (AMI).Methods Ninety-two AMI patients (AMI group) admitted to our hospital from January 2019 to January 2021 were selected and divided into mild disease group (29 cases), moderate disease group (43 cases) and severe disease group (19 cases) according to the degree of coronary artery disease; during the same period, 92 healthy patients in our hospital were selected as the control group. All AMI patients were followed up for 24 months after percutaneous coronary intervention,PCI(PCI), and the patients were divided into adverse cardiovascular events (MACE) group (22 cases) and non-MACE group (70 cases). Real-time fluorescent quantitative PCR was used to detect the expression of lncRNA p21 in serum. Pearson method was used to analyze the correlation between the level of lncRNA p21 and the levels of cTnI and CK-MB. Receiver operating characteristic (ROC) curve was used to evaluate the value of serum lncRNA p21 level in predicting AMI.Results Compared with the control group, the relative expression level of serum lncRNA p21 in the AMI group was lower (P<0.05), and the levels of creatine kinase isoenzyme (CK-MB) and troponin I (cTnI) were higher (P<0.05). Compared with the mild disease group, the relative expression level of serum lncRNA p21 in the moderate and severe disease groups was lower (P<0.05), and the levels of CK-MB and cTnI were higher (P<0.05); compared with the moderate disease group, the relative expression level of serum lncRNA p21 in the severe disease group was lower (P<0.05), and the levels of CK-MB and cTnI were higher (P<0.05). The level of serum lncRNA p21 in AMI patients was negatively correlated with cTnI and CK-MB levels (P<0.05). The ROC curve showed that the area under the curve (AUC) of lncRNA p21 level predicting AMI was 0.861, and its sensitivity and specificity were 70.70% and 89.10%, respectively; lncRNA p21 combined with cTnI, CK-MB level predicting AMI was 0.956, and its sensitivity and specificity were 89.10% and 94.60%, respectively(P<0.05). Compared with the non-MACE group, the relative expression level of serum lncRNA p21 before treatment in the MACE group was lower (P<0.05).Conclusions The expression level of serum lncRNA p21 in AMI patients decreases, and lncRNA p21 has certain diagnostic significance for AMI.