摘要
目的探究动态心电图(DCG)联合血清组蛋白去乙酰化酶4(HDAC4),微小RNA-139-5p(miR-139-5p)在急性心肌梗死(AMI)诊断和预后评估中的应用价值。方法选取2021年1月至2023年1月衡水市人民医院收治的AMI患者102例,根据出院后6个月内是否发生心血管不良事件(MACE)分为良好组66例和不良组36例;另选同期健康体检者70例为对照。所有研究对象行DCG检查;采用酶联免疫法检测血清HDAC4水平,qRT-PCR法检测血清miR-139-5p表达。ROC曲线预测血清HDAC4、miR-139-5p及DCG联合血清HDAC4、miR-139-5p对AMI诊断及预后的价值;四表格法分析DCG对AMI诊断及预后的价值。结果AMI患者血清HDAC4水平显著低于健康体检者,miR-139-5p水平显著高于健康体检者(P<0.05)。良好组患者血清HDAC4水平高于不良组患者,miR-139-5p水平低于不良组患者(P<0.05)。HDAC4诊断AMI的AUC为0.789,敏感度为63.73%,特异度为82.86%;miR-139-5p诊断AMI的AUC为0.791,敏感度为73.53%,特异度为81.43%;DCG诊断AMI的AUC为0.782,敏感度为73.53%,特异度为82.86%。DCG联合血清HDAC4、miR-139-5p水平诊断AMI的AUC为0.916,显著高于单项检测(Z_(HDAC4-联合)=3.735,P<0.001,ZmiR-139-5p-联合=3.467,P<0.001;ZDCG-联合=4.444,P<0.001)。HDAC4诊断AMI患者预后的AUC为0.898,敏感度为80.56%,特异度为86.36%;miR-139-5p诊断AMI患者预后的AUC为0.857,敏感度为77.78%,特异度为80.30%;DCG诊断AMI患者预后的AUC为0.790,敏感度为77.78%,特异度为80.30%;DCG联合血清HDAC4、miR-139-5p水平诊断AMI患者预后的AUC为0.931,显著高于单项检测(Z_(HDAC4-联合)=2.005,P=0.045,ZmiR-139-5p-联合=2.707,P=0.007;ZDCG-联合=3.969,P<0.001)。结论DCG联合血清HDAC4、miR-139-5p水平在AMI的诊断和预后评估中具有重要应用价值。
Objective To explore the application value of dynamic electrocardiogram(DCG)combined with serum histone deacetylase 4(HDAC4)and microRNA-139-5p(miR-139-5p)in the diagnosis and prognosis evaluation of acute myocardial infarction(AMI).Methods:From January 2021 to January 2023,102 AMI patients accepted by Hengshui People’s Hospital were collected.They were grouped into a good group of 66 cases and an poor group of 36 cases based on whether cardiovascular adverse events(MACE)occurred within 6 months after discharge;another 70 healthy examinees were regarded as the control group.All study subjects underwent DCG examination;enzyme-linked immunosorbent assay was applied to detect serum HDAC4 level,qRT-PCR method was applied to detect the expression of miR-139-5p in serum.ROC curve was applied to predict the diagnostic value of serum HDAC4,miR-139-5p,and DCG combined with serum HDAC4,miR-139-5p for AMI and prognosis;four table method was applied to analyze the diagnostic value of DCG for AMI and prognosis.Results The serum HDAC4 level in AMI patients was obviously lower than that in healthy individuals,and the miR-139-5p level was obviously higher than that in healthy individuals(P<0.05).The serum HDAC4 level in the good group was higher than that in the poor group,and the miR-139-5p level was lower than that in the poor group(P<0.05).The AUC of HDAC4 in diagnosing AMI was 0.789,with a sensitivity of 63.73%and a specificity of 82.86%;the AUC of miR-139-5p in diagnosing AMI was 0.791,with a sensitivity of 73.53%and a specificity of 81.43%;the AUC of DCG in diagnosing AMI was 0.782,with a sensitivity of 73.53%and a specificity of 82.86%.The AUC of DCG combined with serum HDAC4 and miR-139-5p levels for diagnosing AMI was 0.916,which was obviously higher than that of single detection(Z_(HDAC4-combination)=3.735,P<0.001,ZmiR-139-5p-combination=3.467,P<0.001;ZDCG-combination=4.444,P<0.001).The AUC of HDAC4 in diagnosing AMI patients was 0.898,with a sensitivity of 80.56%and a specificity of 86.36%;the AUC of miR-139-5p in d
作者
李扬
刘娟
潘晶
汤双榕
LI Yang;LIU Juan;PAN Jing;TANG Shuang-rong(Department of Clinical Electrophysiology,Hengshui People’s Hospital,Hengshui 053000,China;Department of Laboratory,The No.4 People’s Hospital of Hengshui,Hengshui 053000,China)
出处
《中国心血管病研究》
CAS
2024年第3期267-272,共6页
Chinese Journal of Cardiovascular Research
基金
河北省重点研发计划(3082101)。
