摘要
目的分析急性心肌梗死(AMI)患者血浆微小RNA-374a-5p(miR-374a-5p)、白介素-10(IL-10)的表达水平及其与AMI患者经皮冠状动脉介入治疗(PCI)术后冠状动脉无复流的相关性。方法选取2018年11月—2021年2月中南大学湘雅医学院附属海口医院首次确诊并行PCI的AMI患者300例为研究对象,根据PCI术后患者心肌梗死溶栓治疗临床试验(TIMI)血流分级分为无复流组(TIMI<2级)46例和复流组(TIMI≥2级)254例;采用实时荧光定量PCR法检测血浆miR-374a-5p表达,酶联免疫吸附法检测血浆IL-10的表达;Pearson法分析无复流组患者血浆miR-374a-5p、IL-10表达的相关性;通过受试者工作特征曲线(ROC)评估血浆miR-374a-5p、IL-10表达水平对AMI患者PCI术后冠状动脉无复流发生的诊断价值;采用Logistic回归分析AMI患者PCI术后冠状动脉无复流发生的影响因素。结果无复流组血浆miR-374a-5p表达高于复流组,血浆IL-10表达低于复流组(t/P=11.180/0.000、8.188/0.000);无复流组患者血浆miR-374a-5p与IL-10表达呈负相关(r/P=-0.453/0.000);血浆miR-374a-5p、IL-10及二者联合检测诊断AMI患者PCI术后冠状动脉无复流的曲线下面积分别为0.847、0.790、0.900,敏感度分别为0.826、0.692、0.914,特异度分别为0.803、0.788、0.767;Logistic分析显示,血浆miR-374a-5p高表达是AMI患者PCI术后冠状动脉无复流发生的独立危险因素[OR(95%CI)=1.794(1.061~3.033)],而血浆IL-10高表达是其保护因素[OR(95%CI)=0.681(0.501~0.926)]。结论AMI患者PCI术后冠状动脉无复流者血浆miR-374a-5p表达升高,IL-10表达降低,血浆miR-374a-5p、IL-10水平对AMI患者PCI术后冠状动脉无复流发生具有一定的临床诊断价值,二者可能作为AMI患者PCI术后冠状动脉无复流发生的潜在生物学指标。
Objective To analyze the expression levels of plasma microRNA-374a-5p(miR-374a-5p)and interleukin 10(IL-10)in patients with acute myocardial infarction(AMI)and their correlation with coronary artery no reflow after percutaneous coronary intervention(PCI).Methods From November 2018 to February 2021,300 patients with AMI who were diagnosed with PCI for the first time in Haikou Hospital of Xiangya Medical College of Central South University were selected as the research objects.According to the clinical trial of thrombolytic therapy for myocardial infarction in patients after PCI(TIMI)blood flow classification divided into no-reflow group(TIMI<2)46 cases and reflow group(TIMI≥2)254 cases.Real-time fluorescent quantitative PCR was used to detect the expression of plasma miR-374a-5p,and the enzyme-linked immunosorbent method was used to detect the expression of plasma IL-10.Pearson method was used to analyze the correlation between the expression of plasma miR-374a-5p and IL-10 in the non-reflow group.The receiver operating characteristic curve(ROC)was used to evaluate the value of plasma miR-374a-5p and IL-10 expression in the diagnosis of coronary artery reflow in patients with AMI after PCI.Logistic regression was used to analyze the influencing factors of coronary artery no-reflow after PCI in AMI patients.Results The expression of plasma miR-374a-5p in the no-reflow group was higher than that of the reflow group,and the expression of plasma IL-10 was lower than that of the reflow group(t/P=11.180/0.000,8.188/0.000).Plasma miR-374a-5p and IL-10 expression in the no-reflow group were negatively correlated(r/P=-0.453/0.000).The area under the curve of plasma miR-374a-5p,IL-10 and the combined detection of the two in diagnosing coronary artery no-reflow after PCI in AMI patients were 0.847,0.790,and 0.900,respectively,the sensitivity was 0.826,0.692,0.914,and the specificity was 0.803,0.788,0.767.Logistic analysis showed that the high expression of plasma miR-374a-5p is an independent risk factor for the occurrence
作者
王燕英
陈海荣
张伟
李名兰
Wang Yanying;Chen Hairong;Zhang Wei;Li Minglan(Department of General Medicine,Haikou Hospital Affiliated to Xiangya Medical College of Central South University,Hainan Province,Haikou 570208,China;不详)
出处
《疑难病杂志》
CAS
2021年第9期889-893,共5页
Chinese Journal of Difficult and Complicated Cases
基金
海南省卫生健康行业科研项目(20A200536)。
