摘要
目的探讨血浆微小核糖核酸(microRNA,miR)-23a及D-二聚体浓度对急性主动脉夹层(acute aortic dissection,AAD)患者的诊断及预后判断价值。方法选取2017年1月至2020年12月儋州市人民医院收治的A型AAD患者136例和60名健康对照者作为研究对象,根据A型AAD患者住院期间的预后情况分为存活组(n=96例)和死亡组(n=40例),检测各组研究对象血浆miR-23a及D-二聚体浓度。应用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血浆miR-23a及D-二聚体浓度对A型AAD患者诊断及预测死亡的价值。应用多因素Logistic回归分析影响A型AAD患者死亡的危险因素。结果AAD组患者血浆miR-23a浓度(1.38±0.45 vs.0.24±0.06)及D-二聚体浓度[(6.32±1.74)mg/L vs.(0.35±0.07)mg/L]均明显高于对照组,差异有统计学意义(P<0.001)。死亡组患者血浆miR-23a浓度[(2.08±0.72)vs.(0.63±0.56)]及D-二聚体浓度[(8.70±2.28)vs.(3.66±1.34)mg/L]均明显高于存活组,差异有统计学意义(P<0.001)。ROC分析结果显示,miR-23a及D-二聚体两项联合诊断A型AAD的曲线下面积(0.910,95%CI:0.852~0.972)最大,miR-23a及D-二聚体两项联合预测A型AAD死亡的曲线下面积(0.938,95%CI:0.877~0.995)最大。多因素Logistic回归分析结果显示血浆miR-23a(OR=2.246,95%CI:1.630~5.171)及D-二聚体(OR=1.752,95%CI:1.206~3.218)浓度升高是影响A型AAD患者死亡的独立危险因素(P<0.05)。结论A型AAD患者血浆miR-23a及D-二聚体浓度明显升高,两项联合检测对A型AAD诊断和预后判断具有较好的参考价值。
Objectives To investigate the value of plasma concentrations of microRNA(miR)-23a and D-dimer in the diagnosis and prognosis of patients with A type acute aortic dissection(AAD).Methods From January 2017 to December 2020,136 patients with A type AAD and 60 healthy controls were selected as the study objects in Danzhou City People′s Hospital.According to the prognosis during hospitalization,patients with A type AAD were divided into survival group(n=96)and death group(n=40).The plasma concentrations of miR-23a and D-dimer were compared among groups.The value of plasma concentrations of miR-23a and D-dimer in the diagnosis and prediction of death in patients with A type AAD were analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regres⁃sion was used to analyze the risk factors affecting the death of patients with A type AAD.Results The plasma concen⁃trations of miR-23a(1.38±0.45 vs.0.24±0.06)and D-Dimer[(6.32±1.74)mg/L vs.(0.35±0.07)mg/L]in AAD group were significantly higher than those in control group(P<0.001).The plasma concentrations of miR-23a(2.08±0.72 vs.0.63±0.56)and D-Dimer[(8.70±2.28)mg/L vs.(3.66±1.34)mg/L]in death group were significantly higher than those in survival group(P<0.001).ROC curve showed that the area under the curve(0.910,95%CI:0.852-0.972)with two combinations of miR-23a and D-dimer in the diagnosis of A type AAD were the largest,and the area under the curve(0.938,95%CI:0.877-0.995)of the two combined predictors of A type AAD death were the largest.Multivariate Logistic regression analysis showed that the elevated plasma concentrations of miR-23a(OR=2.246,95%CI:1.630-5.171)and D-Dimer(OR=1.752,95%CI:1.206-3.218)were independent risk factors for death in patients with A type AAD(P<0.05).Conclusions The plasma concentrations of miR-23a and D-dimer in patients with A type AAD significantly increased,and the combination of the two items above has a better reference value in the diagnosis and prognosis of patients with A type AAD.
作者
洪燕
郭海萍
陈金连
黄维芬
张志东
HONG Yan;GUO Hai-ping;CHEN Jin-lian;HUANG Wei-fen;ZHANG Zhi-dong(Department of Cardio-Thoracic Surgery,Danzhou City People′s Hospital,Danzhou,Hainan 571799,China)
出处
《岭南心血管病杂志》
CAS
2022年第4期312-317,共6页
South China Journal of Cardiovascular Diseases
