急性ST段抬高型心肌梗死患者血清miR-1-3p、H-FABP水平变化及临床意义(1)
[摘要] 目的 探討急性ST段抬高型心肌梗死(STEMI)患者血清miR-1-3p、心脏型脂肪酸结合蛋白(H-FABP)的表达，并分析二者对STEMI的诊断价值。 方法 选取2016年12月～2019年6月在大连医科大学附属第一医院(以下简称“我院”)诊治的120例STEMI患者为STEMI组，另选取同期我院120例心功能正常者为非STEMI组。采用实时荧光定量PCR法检测血清miR-1-3p表达，采用酶联免疫吸附法检测血清H-FABP、N端脑钠肽前体(NT-proBNP)水平，采用全自动生化分析仪检测总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平;采用彩色超声诊断仪测量左室射血分数(LVEF)、左室舒张末期内径(LVEDD)。采用Pearson相关性分析STEMI患者血清miR-1-3p、H-FABP与脂代谢指标、心功能指标的相关性;并采用受试者操作特征曲线(ROC)分析血清miR-1-3p、H-FABP及联合检测STEMI的诊断价值。 结果 STEMI组血清miR-1-3p表达及LVEF低于非STEMI组，血清H-FABP、TC、LDL-C、NT-proBNP水平及LVEDD高于非STEMI组，差异均有统计学意义(均P < 0.05)。两组血清TG比较，差异无统计学意义(P > 0.05)。STEMI组血清miR-1-3p与TC、LDL-C、NT-proBNP、LVEDD、H-FABP均呈负相关(r < 0，P < 0.05)，与LVEF呈正相关(r > 0，P < 0.05);血清H-FABP与TC、LDL-C、NT-proBNP、LVEDD均呈正相关(r > 0，P < 0.05)，与LVEF、miR-1-3p呈负相关(r < 0，P < 0.05);二者与TG均无明显相关性(P > 0.05)。ROC分析显示，血清miR-1-3p、H-FABP对STEMI均有一定的诊断价值，二者联合检测的诊断价值高于单独检测[AUC=0.815，95%CI(0.728～0.846)]。 结论 STEMI患者血清miR-1-3p呈低表达，H-FABP呈高表达，二者均与患者的脂代谢指标、心功能指标存在一定的相关性，二者联合检测可进一步提高对STEMI的诊断价值。
[关键词] 急性ST段抬高型心肌梗死;miR-1-3p;心脏型脂肪酸结合蛋白;诊断价值
[中图分类号] R542.22 [文献标识码] A [文章编号] 1673-7210(2020)03(c)-0168-05
[Abstract] Objective To investigate the expression of serum miR-1-3p and Heart-type fatty acid binding protein (H-FABP) in patients with acute ST-segment elevation myocardial infarction (STEMI)， and to analyze the diagnostic value of both to STEMI. Methods A total of 120 STEMI patients treated in the First Affiliated Hospital of Dalian Medical University (hereinafter referred to as “our hospital”) from December 2016 to June 2019 were selected as the STEMI group， and another 120 patients with normal cardiac function in our hospital during the same period were selected as the non-STEMI group. The expression of serum miR-1-3p was detected by real-time fluorescence quantitative PCR. Serum levels of H-FABP and N-terminal pro B-type natriuretic peptide (NT-proBNP) were determined by enzyme-linked immunosorbent assay. The levels of total cholesterol (TC)， low density lipoprotein cholesterol (LDL-C) and triacylglycerol (TG) were measured by automatic biochemical analyzer. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by color ultrasound diagnostic instrument. Pearson correlation was used to analyze the correlation of serum miR-1-3p and H-FABP with lipid metabolism index and cardiac function index in STEMI patients. The diagnostic value of serum miR-1-3p， H-FABP and combined detection of STEMI was analyzed by using the receiver operating characteristic curve (ROC). Results Serum miR-1-3p expression and LVEF in the STEMI group were lower than those in the non-STEMI group， and the levels of serum H-FABP， TC， LDL-C， NT-proBNP and LVEDD in STEMI group were higher than those in the non-STEMI group， with statistically significant differences (all P < 0.05). There was no significant difference in serum TG between the two groups (P > 0.05). Serum miR-1-3p in STEMI group was negatively correlated with TC， LDL-C， NT-proBNP， LVEDD， and H-FABP (r < 0， P < 0.05)， and positively correlated with LVEF (r > 0， P < 0.05). Serum H-FABP was positively correlated with TC， LDL-C， NT-proBNP and LVEDD (r > 0， P < 0.05)， and negatively correlated with LVEF and miR-1-3p (r < 0， P < 0.05). There was no significant correlation between them and TG (P > 0.05). ROC analysis showed that serum miR-1-3p and H-FABP had certain diagnostic value for STEMI， and the diagnostic value of the combined detection was higher than that of the single detection [AUC=0.815， 95%CI (0.728-0.846)]. Conclusion Serum miR-1-3p was low expressed and H-FABP was high expressed in STEMI patients， both of which were correlated with lipid metabolism index and cardiac function index of the patients to some extent. The combined detection of the two could further improve the diagnostic value of STEMI., http://www.100md.com(张荣峰 李丹娜 董颖雪)
[关键词] 急性ST段抬高型心肌梗死;miR-1-3p;心脏型脂肪酸结合蛋白;诊断价值
[中图分类号] R542.22 [文献标识码] A [文章编号] 1673-7210(2020)03(c)-0168-05
[Abstract] Objective To investigate the expression of serum miR-1-3p and Heart-type fatty acid binding protein (H-FABP) in patients with acute ST-segment elevation myocardial infarction (STEMI)， and to analyze the diagnostic value of both to STEMI. Methods A total of 120 STEMI patients treated in the First Affiliated Hospital of Dalian Medical University (hereinafter referred to as “our hospital”) from December 2016 to June 2019 were selected as the STEMI group， and another 120 patients with normal cardiac function in our hospital during the same period were selected as the non-STEMI group. The expression of serum miR-1-3p was detected by real-time fluorescence quantitative PCR. Serum levels of H-FABP and N-terminal pro B-type natriuretic peptide (NT-proBNP) were determined by enzyme-linked immunosorbent assay. The levels of total cholesterol (TC)， low density lipoprotein cholesterol (LDL-C) and triacylglycerol (TG) were measured by automatic biochemical analyzer. Left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by color ultrasound diagnostic instrument. Pearson correlation was used to analyze the correlation of serum miR-1-3p and H-FABP with lipid metabolism index and cardiac function index in STEMI patients. The diagnostic value of serum miR-1-3p， H-FABP and combined detection of STEMI was analyzed by using the receiver operating characteristic curve (ROC). Results Serum miR-1-3p expression and LVEF in the STEMI group were lower than those in the non-STEMI group， and the levels of serum H-FABP， TC， LDL-C， NT-proBNP and LVEDD in STEMI group were higher than those in the non-STEMI group， with statistically significant differences (all P < 0.05). There was no significant difference in serum TG between the two groups (P > 0.05). Serum miR-1-3p in STEMI group was negatively correlated with TC， LDL-C， NT-proBNP， LVEDD， and H-FABP (r < 0， P < 0.05)， and positively correlated with LVEF (r > 0， P < 0.05). Serum H-FABP was positively correlated with TC， LDL-C， NT-proBNP and LVEDD (r > 0， P < 0.05)， and negatively correlated with LVEF and miR-1-3p (r < 0， P < 0.05). There was no significant correlation between them and TG (P > 0.05). ROC analysis showed that serum miR-1-3p and H-FABP had certain diagnostic value for STEMI， and the diagnostic value of the combined detection was higher than that of the single detection [AUC=0.815， 95%CI (0.728-0.846)]. Conclusion Serum miR-1-3p was low expressed and H-FABP was high expressed in STEMI patients， both of which were correlated with lipid metabolism index and cardiac function index of the patients to some extent. The combined detection of the two could further improve the diagnostic value of STEMI., http://www.100md.com(张荣峰 李丹娜 董颖雪)
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