AMI患者发病后血浆UCA1、CK-MB、cTnI变化及其诊断价值分析

目的分析急性心肌梗死(AMI)患者发病后血浆尿路上皮癌相关1(UCA1)、肌酸激酶同工酶MB(CK-MB)、肌钙蛋白I(cTnI)变化及其诊断价值。方法选取2016年7月至2017年6月本院收治的80例AMI患者及30例健康志愿者为研究对象,分别纳入AMI组、对照组,采用实时荧光定量聚合酶链反应法(qPCR)检测UCA1,比较两组入院后0~2、2~6、6~12、12~24、24~48、48~72、72~96 h血浆UCA1及CK-MB、cTnI水平,分析AMI组中合并不同基础疾病(高血压、糖尿病、高脂血症)患者UCA1、CK-MB、cTnI水平差异。结果与对照组比较,AMI组UCA1整体表达水平下调,且AMI组入院后0~48 h UCA1低于对照组(P<0.05),AMI组中UCA1在6~12 h降至最低(P<0.05),后升高(P<0.05),至入院后48~72 h、72~96 h与对照组比较差异无统计学意义(P>0.05);AMI组入院后2~48 h CK-MB、cTnI水平高于对照组(P<0.05),CK-MB在6~12 h达峰值,cTnI在12~24 h达峰值(P<0.05);AMI组中单纯AMI、合并高血压、合并糖尿病、合并高脂血症、合并2种及以上患者UCA1、CK-MB、cTnI表达水平分别两两比较差异无统计学意义(P>0.05);入院后6~12 h UCA1诊断AMI的灵敏度、特异度、准确度、ROC曲线下面积分别为85.42%、83.14%、86.11%、0.954,均较CK-MB、cTnI高。结论AMI患者发病后血浆UCA1表达水平可作为其潜在诊断标志物及治疗靶点,尤其在入院后6~12 h的UCA1有较高监测价值。

Changes of Plasma UCA1,CK-MB and cTnI in Patients with AMI after Onset and Their Diagnostic Value

Objective To analyze the changes of plasma urothelial carcinoma associated 1(UCA1),C reatine kinase isoenzyme MB(CK?MB)and cardiac troponin I(cTnI)in patients with acute myocardial infarction(AMI)after onset and their diagnostic value.Methods 80 cases of AMI patients and 30 cases of healthy volunteers admitted to the hospital from July 2016 to June 2017 were selected for the study and they were included between the two groups respectively.UCA1 was detected by real?time fluorescence quantitative polymerase chain reaction(qPCR).The levels of UCA1,CK?MB and cTnI at 0~2,2~6,6~12,12~24,24~48,48~72 and 72~96 h after admission were compared between AMI group and the control group.The differences in levels of UCA1,CK?MB and cTnI in patients with AMI combined with different underlying diseases(hypertension,diabetes mellitus,hyperlipemia)were analyzed.The diagnostic value of UCA1,CK?MB and cTnI for AMI was evaluated.Results Compared with the control group,the overall expression levels of UCA1 in the AMI group were down?regulated.The UCA1 level in the AMI group within 0~48 h after admission was lower than that in the control group(P<0.05).The UCA1 level in AMI group was decreased to the lowest at 6~12 h(P<0.05)and then increased(P<0.05).There was no significant difference in the UCA1 level at 48~72 and 72~96 h after admission between the two groups(P>0.05).The levels of CK?MB and cTnI were higher in the AMI group than in the control group at 2 to 48h after admission(P<0.05).The CK?MB reached the peak at 6~12 h and the cTnI reached the peak at 12~24 h in AMI group(P<0.05).There was no significant difference in the expression levels of UCA1,CK?MB and cTnI between patients with simple AMI,complicated with any two or more of hypertension,diabetes mellitus and hyperlipidemia(P>0.05).The sensitivity,specificity,accuracy and area under the ROC curve were 85.42%,83.14%,86.11%and 0.954 respectively in the diagnosis of AMI by UCA1 at 6~12 h after admission,higher than those by CK?MB and cTnI.Conclusion The UCA1 expression level in AMI patients after onset may be a potential diagnostic marker and therapeutic target,especially with high monitoring value when UCA1 is at 6~12 h after admission.