急性主动脉夹层患者血浆miR-30a及D-二聚体水平检测对临床预后判断价值

目的　探讨血浆微小核糖核酸 (miR)-30a及 D-二聚体 (D-dimer, D-D)水平对急性主动脉夹层（ acute aortic dissection ，AAD）预后判断价值。方法　选取 2018年 1月～ 2020年 12月海口市第三人民医院收治的 AAD患者 152例和 65例健康对照组作为研究对象，根据 AAD患者住院期间的预后情况分为存活组（ n=107例）和死亡组（ n=45例），检测各组血浆 miR-30a及 D-二聚体水平。应用受试者工作特征（ ROC）曲线分析血浆 miR-30a及 D-二聚体水平预测 AAD死亡的价值。结果　AAD组血浆 miR-30a（1.93±0.78）及 D-二聚体（6.28±1.72μg/ml）水平均明显高于对照组（0.72±0.25，0.36±0.08μg/ml），差异有统计学意义（ t=13.758, 16.814，均 P<0.001）。死亡组血浆 miR-30a（2.42±1.13）及 D-二聚体（ 8.62±2.24μg/ml）水平均明显高于存活组（ 1.30±0.56，3.64±1.35μg/ml），差异有统计学意义（ t=11.624, 14.735，均 P<0.001）。ROC曲线显示， miR-30a及 D-二聚体两项联合预测 AAD死亡的曲线下面积（ 0.936，95%CI: 0.875～ 0.992）最大，其敏感度和特异度分别为 94.0%，88.6%。结论　AAD患者血浆 miR-30a及 D-二聚体水平明显升高，两项联合检测对 AAD预后判断具有较好的价值。

Clinical Prognostic Value of Plasma miR-30a and D-dimer Levels in Patients with Acute Aortic Dissection

Objective　To investigate the value of plasma miR-30a and D-dimer(D-D) levels in prognosis of acute aortic dissection (AAD). Methods　The 152 AAD patients and 65 healthy controls in the Third People’s Hospital of Haikou from January 2018 to December 2020 were selected as the research objects. According to the prognosis of AAD patients during hospitalization, they were divided into survival group (n=107) and death group (n=45). The levels of plasma miR-30a and D-dimer were detected in each group. The value of plasma miR-30a and D-dimer levels in prediction of death in AAD were analyzed by ROC curve. Results　The levels of miR-30a (1.93±0.78) and D-dimer (6.28±1.72μg/ml ) in AAD group were significantly higher than those in control group（0.72±0.25，0.36±0.08μg/ml）, the differences were statistically significant（t=13.758, 16.814, all P<0.001）. The levels of miR-30a (2.42±1.13 ) and D-dimer (8.62±2.24μg/ml) in the dead group were significantly higher than those in the survival group（1.30±0.56，3.64±1.35 μg/ml）, the differences were statistically significant（t=11.624, 14.735, all P<0.001）. ROC curve showed that the area under the area under the curve (0.936，95%CI:0.875~0.992) of the two combined predictors of AAD death were the largest, with sensitivity and specificity of 94.0%，88.6%. Conclusion　The levels of plasma miR-30a and D-dimer in patients with AAD were significantly increased, and the combined of the two items has a better value in the prognosis of AAD.