摘要
目的 探究冠心病病人外周血微RNA-133b(miR-133b)表达水平,并分析其表达与病人预后的关系。方法 选取2019年7月至2021年1月于华北石油管理局总医院就诊的冠心病病人95例,其中稳定性冠心病(SACD)病人54例为SACD组,急性冠状动脉综合征(ACS)41例为ACS组,另选同期该院进行体检的健康人群60例作为对照组。采用实时荧光定量PCR法检测血清miR-133b水平;随访6个月,根据是否出现主要心脏不良事件,分为预后不良组(出现主要心脏不良事件,33例)和预后良好组(未出现主要心脏不良事件,62例)。采用Spearman相关性分析检验血清miR-133b水平与Gensini评分的关系;采用多因素logistic回归分析影响冠心病病人预后的危险因素;采用受试者操作特征曲线(ROC曲线)分析血清miR-133b水平对冠心病病人预后不良的预测价值。结果 SACD组、ACS组身体质量指数、高血压、吸烟史及血脂异常者比例高于对照组(P<0.05),ACS组Gensini评分、病变支数≥3支占比高于SACD组(P<0.05)。ACS组、SACD组血清miR-133b(1.59±0.15比1.36±0.12比1.02±0.05)水平均高于对照组(P<0.05),ACS组血清miR-133b水平高于SACD组(P<0.05)。SACD组病人血清miR-133b水平与Gensini评分呈正相关(r=0.58,P<0.001),ACS组病人血清miR-133b水平与Gensini评分也呈正相关(r=0.57,P<0.001)。预后不良组病人Gensini评分、血清miR-133b水平及病变支数≥3支占比高于预后良好组(P<0.05)。Gensini评分、病变支数、miR-133b均为影响冠心病病人预后的危险因素(P<0.05)。血清miR-133b水平预测冠心病病人预后不良的曲线下面积为0.83,最佳截断值为1.55,灵敏度高达97.0%,特异度为64.5%。结论 冠心病病人血清miR-133b水平升高,对病人的预后不良有一定的预测价值。
Objective To explore the expression level of microRNA-133b(miR-133b) in peripheral blood of patients with coronary artery disease,and to analyze the relationship between its expression and the prognosis of patients.Methods Ninety-five patients with coronary heart disease(CHD) in the North China Petroleum Administration General Hospital(NCPAGH) from July 2019 to January 2021 were selected,of which 54 patients with stable coronary heart disease(SACD) were selected as the SACD group,and 41 patients with acute coronary syndromes(ACS) were selected as the ACS group,and 60 healthy people who underwent medical checkups at the NCPAGH during the same period were also selected as the control group.The real-time fluorescence quantitative PCR method was used to detect the serum miR-133b level.The patients were followed up for 6 months,according to whether there were major adverse cardiac events,they were assigned into poor prognosis group(33 cases with major adverse cardiac events) and good prognosis group(62cases without major adverse cardiac events).Spearman test was used to analyze the relationship between serum miR-133b level and Gensini score;multivariate logistic regression was used to analyze the risk factors affecting the prognosis of coronary artery disease patients;ROC curve was used to analyze the predictive value of serum miR-133b level for poor prognosis of coronary artery disease patients.Results The body mass index,proportions of people with hypertension,smoking history and dyslipidemia in SACD group and ACS group were higher than those in the control group(P<0.05);the Gensini score and the proportion of lesions ≥ 3 in ACS group were higher than those in SACD group(P<0.05).Serum miR-133b(1.59±0.15 vs.1.36±0.12 vs.1.02±0.05) levels were higher in the ACS and SACD groups than those in the control group(P<0.05),and serum miR-133b levels were higher in the ACS group than those in the SACD group(P<0.05).The level of serum miR-133b in SACD group was positively correlated with Gensini score(r=0.58,P<0.001),and the level of serum miR-133b in ACS group was also positively correlated with Gensini score(r=0.57,P<0.001).The Gensini score,serum miR-133b level and the proportion of lesions ≥ 3 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Gensini score,number of lesions and miR-133b were all risk factors affecting the prognosis of coronary artery disease patients(P<0.05).The area under the curve of serum miR-133b level predicting poor prognosis of coronary artery disease patients was 0.83,the optimal cutoff value was 1.55,the sensitivity was as high as 97.0%,and the specificity was 64.5%.Conclusion Elevated serum miR-133b levels in patients with coronary artery disease have predictive value for poor patient prognosis.
作者
刘少云
张红
刘艳静
吴玮
刘志敏
LIU Shaoyun;ZHANG Hong;LIU Yanjing;WU Wei;LIU Zhimin(Department of Cardiology,General Hospital of North China Petroleum Administration,Cangzhou,Hebei 062552,China;Department of Geriatrics,General Hospital of North China Petroleum Administration,Cangzhou,Hebei 062552,China;Department of Endocrinology,Tianjin Second Hospital,Tianjin 300143,China)
出处
《安徽医药》
CAS
2024年第3期572-576,共5页
Anhui Medical and Pharmaceutical Journal
基金
中国石油天然气股份有限公司华北油田分公司科技项目(2016-HB-G0401)。
