| 陈晓茹.血清微小RNA-208a、微小RNA-208b水平对急性心肌梗死患者PCI术后预后有预测价值[J].内科急危重症杂志,2026,32(4):383-386 |
| 血清微小RNA-208a、微小RNA-208b水平对急性心肌梗死患者PCI术后预后有预测价值 |
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| DOI：10.11768/nkjwzzzz.202410121050 |
| 中文关键词: 微小RNA-208a 微小RNA-208b 急性心肌梗死 经皮冠状介入术 |
| 英文关键词: MicroRNA-208a MicroRNA-208b Acute myocardial infarction Percutaneous coronary intervention |
| 基金项目:福建医学科技青年培育项目（21FBQN20210102）；厦门市科技计划项目（3502Z20234018） |
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| 中文摘要: |
| 摘要 目的：分析血清miRNA-208a、miRNA-208b水平与急性心肌梗死(AMI)经皮冠状动脉介入治疗（PCI）患者预后的关系。方法：纳入行PCI治疗的AMI患者80例为研究组，同时纳入稳定性冠心病患者80例为对照组，检测并比较2组血清miRNA-208a、miRNA-208b表达水平，随访3年，根据有无发生不良心血管事件设为预后不良与预后良好组，采用Logistic回归法行不同预后组间多因素分析，以受试者工作特征（ROC）曲线评估血清miRNA-208a、miRNA-208b水平对AMI患者PCI术后预后的预测价值。结果：研究组入院时血清miRNA-208a、miRNA-208b高于对照组（P均＜0.05）；PCI治疗后血清miRNA-208a、miRNA-208b低于治疗前（P＜0.05）；随访3年，研究组预后良好51例，预后不良29例；预后良好组与预后不良组间心功能[左室射血分数（LVEF）、左室舒张末期内径（LVEDD）]、血清脑钠肽（BNP）、C反应蛋白（CRP）、糖尿病、冠脉解剖情况、肌钙蛋白（cTnT）以及血清miRNA-208a、miRNA-208b差异显著（P均＜0.05）；Logistic多因素回归分析显示，LVEDD、LVEF、BNP、CRP、糖尿病、冠脉狭窄或闭锁、cTnT以及血清miRNA-208a、miRNA-208b为AMI患者PCI术后预后的独立危险因素（P均＜0.05）；ROC曲线预测模型最佳临界值为0.907，miRNA-208a联合miRNA-208b诊断灵敏度为96.55%，特异性为92.16%，曲线下面积（AUC）为0.906（95%CI：0.816-0.959），高于各单一指标（P<0.05）。结论：血清miRNA-208a、miRNA-208b高表达为AMI患者PCI术后预后不良有关，2项联合检测对预后预测价值高。 |
| 英文摘要: |
| Abstract Objective: To analyze the relationship between serum miRNA-208a and miRNA-208b levels and the prognosis of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: A total of 80 patients with AMI undergoing PCI were enrolled as the study group, and 80 patients with stable coronary artery disease were enrolled as the control group. Serum expression levels of miRNA-208a and miRNA-208b were measured and compared between the two groups, and all patients were followed up for 3 years. Based on the occurrence of major adverse cardiovascular events, patients were divided into a poor-prognosis group and a good-prognosis group. Multivariate analysis between different prognostic groups was performed using logistic regression. The predictive value of serum miRNA-208a and miRNA-208b levels for prognosis in AMI patients after PCI was evaluated using receiver operating characteristic (ROC) curves. Results: Serum miRNA-208a and miRNA-208b levels on admission in the study group were significantly higher than those in the control group (both P< 0.05). After PCI, serum miRNA-208a and miRNA-208b levels were significantly lower than before treatment (P< 0.05). At the 3-year follow-up, 51 patients in the study group had a good prognosis and 29 had a poor prognosis. There were significant differences between the good-prognosis and poor-prognosis groups in cardiac function [left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD)], serum brain natriuretic peptide (BNP), C-reactive protein (CRP), diabetes mellitus, coronary anatomy status, cardiac troponin T (cTnT), and serum miRNA-208a and miRNA-208b levels (all P< 0.05). Logistic multivariate regression analysis showed that LVEDD, LVEF, BNP, CRP, diabetes mellitus, coronary artery stenosis or occlusion, cTnT, and serum miRNA-208a and miRNA-208b were independent risk factors for prognosis in AMI patients after PCI (all P< 0.05). The optimal cutoff value of the ROC curve prediction model was 0.907. The combined detection of miRNA-208a and miRNA-208b had a sensitivity of 96.55%, a specificity of 92.16%, and an area under the curve (AUC) of 0.906 (95%CI: 0.816–0.959), which was higher than that of each single indicator (P< 0.05). Conclusion: High serum expression levels of miRNA-208a and miRNA-208b are associated with poor prognosis in AMI patients after PCI. The combined detection of these two markers has high predictive value for prognosis. |
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