老年急性心肌梗死患者血清微小核糖核酸-302b表达及其临床意义

目的探讨血清微小核糖核酸(microRNA,miR)-302b在老年急性心肌梗死(acute myocardial infarction,AMI)患者中的表达及其临床意义。方法选取海南三林旅业开发有限公司澄迈富力红树湾医院内科和海南省人民医院收治的136例老年AMI患者和50例正常对照组,比较两组血清miR-302b、心肌肌钙蛋白I(myocardial troponin I,cTnI)及肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)浓度变化。应用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清miR-302b、cTnI及CK-MB浓度对老年AMI患者诊断的价值。结果AMI组血清miR-302b(4.19±1.27 vs.0.48±0.14,P<0.01)、cTnI[(3.14±1.32)ng/mL vs.(0.03±0.01)ng/mL,P<0.01]及CK-MB[(73.42±19.20)U/L vs.(11.64±2.18)U/L,P<0.01]均明显高于对照组,差异有统计学意义。ROC分析结果显示,miR-302b、cTnI及CK-MB诊断AMI的临界值分别为2.64、1.48 ng/mL、60.75 U/L,3项联合诊断老年AMI的曲线下面积=0.933(95%CI:0.870~0.982)最大,其敏感度和特异度为94.6%和89.0%。结论血清miR-302b在老年AMI患者中呈高表达,与cTnI、CK-MB联合检测有助于提高老年AMI诊断的准确性。

Serum expression of microRNA-302b in elderly patients with acute myocardial infarction and its clinical significance

Objectives To investigate the serum expression of microRNA(miR)-302b in elderly patients with acute myocardial infarction(AMI)and its clinical significance.Methods Totally 136 elderly patients with AMI admitted to Hainan Silver Kang Medical Hospital Affiliated to Chengmai Mangrove Bay Hospital and Hainan Provincial People′s Hospita and 50 normal controls were selected.Serum concentrations of miR-302b,myocardial troponin I(cTnI)and creatine kinase isoenzyme(CK-MB)between the two groups were compared.Value of serum concentrations of miR-302b,cTnI and CK-MB in the diagnosis of elderly patients with AMI was analyzed by receiver operating characteristic curve(ROC).Results Serum concentrations of miR-302b(4.19±1.27 vs.0.48±0.14,P<0.01),cTnI[(3.14±1.32)ng/mL vs.(0.03±0.01)ng/mL,P<0.01]and CK-MB[(73.42±19.20)U/L vs.(11.64±2.18)U/L,P<0.01]in AMI group were significantly higher than those in control group.ROC analysis showed that the critical values of miR-302b,cTnI and CK-MB in the diagnosis of elderly patients with AMI were 2.64,1.48 ng/mL and 60.75 U/L,respectively.Area under the curve[0.933(95%CI:0.870-0.982)]of the three indexes combined diagnosis of elderly patients with AMI was the largest,with sensitivity and specificity of 94.6%and 89.0%.Conclusions Serum expression of miR-302b is high in elderly patients with AMI,and the combined detection with cTnI and CK-MB is helpful to improve the accuracy of AMI diagnosis in elderly patients.