循环微小RNA对高龄急性心肌梗死的早期诊断价值

目的探讨循环微小RNA(microRNA,miR-19b、miR-223和miR-483-5p)在高龄急性心肌梗死(AMI)的早期诊断价值。方法连续入选因"胸痛或其等危症"就诊于我院且疑诊AMI的年龄≥85岁高龄患者70例,按性别和年龄1:1配对原则,分为AMI组35例和非AMI组35例。收集患者入院时首份血标本,检测循环microRNA表达水平。比较2组循环miR-19b、miR-223和miR-483-5p表达差异,绘制ROC曲线评价循环microRNA对高龄AMI的早期诊断价值。结果与非AMI组比较,AMI组miR-19b、miR-223和miR-483-5p表达显著上调(3.42±0.11 vs 1.00±0.00,P<0.01;2.25±0.12 vs 1.00±0.00,P<0.05;2.51±0.12 vs 1.00±0.00,P<0.01)。ROC曲线分析显示,miR-19b、miR-483-5p和血清肌钙蛋白I诊断高龄AMI的曲线下面积(AUC)分别为0.73(95%CI:0.64~0.83)、0.71(95%CI:0.61~0.80)和0.64(95%CI:0.53~0.74),miR-19b、miR-483-5p诊断AMI价值优于血清肌钙蛋白I;miR-19b、miR-223和miR-483-5p三者联合诊断高龄AMI的AUC为0.82(95%CI:0.74~0.90)。结论循环miR-19b和miR-483-5p表达上调有助AMI早期诊断,有望成为高龄AMI的新型诊断标志物。

Value of circulating microRNAs in early diagnosis of elderly acute myocardial infarction patients

Objective To study the value of circulating microRNA(miR-19 b,miR-223 and miR-483-5 p) in early diagnosis of elderly acute myocardial infarction(AMI) patients.Methods Seventy ≥85 years old patients admitted to our hospital due to "chest pain" and suspected AMI were divided into AMI group and AMI-free group.The first blood sample was taken from the patients on admission for detecting the expression of circulating microRNA.The expressions of miR-19 b,miR-223 and miR-483-5 p were compared between the two groups.The ROC curves were plotted for assessing the value of circulating miR-19 b,miR-223 and miR-483-5 p in early diagnosis of elderly AMI patients.Results The expression levels of miR-19 b,miR-223 and miR-483-5 p were significant higher in AMI group than in AMI-free group(P<0.05,P<0.01).The ROC curve analysis showed that the AUC for miR-19 b,miR-483-5 p and serum troponin-I was 0.73(95%CI:0.64-0.83),0.71(95%CI:0.61-0.80) and 0.64(95%CI:0.53-0.74) respectively.The value of miR-19 b and miR-483-5 p alone was higher than that of serum troponin-I in early diagnosis of elderly AMI patients.The AUC for combined miR-19 b,miR-483-5 p and serum troponin-1 in early diagnosis of elderly AMI patients was 0.82(95%CI:0.74-0.90).Conclusion Elevated expression levels of miR-19 b and miR-483-5 p contribute to the early diagnosis of AMI and can thus become a new diagnostic marker for elderly AMI patients.