中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
Chinese Journal of Laboratory Medicine
2015年
10期
686-690
,共5页
吴嘉%宋佳希%刘婷%牛冬梅%汪俊军
吳嘉%宋佳希%劉婷%牛鼕梅%汪俊軍
오가%송가희%류정%우동매%왕준군
冠状动脉疾病%急性冠状动脉综合征%微RNAs%生物学标记
冠狀動脈疾病%急性冠狀動脈綜閤徵%微RNAs%生物學標記
관상동맥질병%급성관상동맥종합정%미RNAs%생물학표기
Coronary artery disease%Acute coronary syndrome%microRNAs%Biological markers
目的:探讨急性冠状动脉综合征(ACS)和稳定性冠状动脉性心脏病(SCAD)患者血清miR-133a的水平变化及临床价值。方法回顾性研究。选取2011年10月至2012年10月期间南京军区南京总医院住院的64例ACS、62例SCAD患者及70名常规体检的健康对照者,其中ACS和SCAD根据欧洲心脏病学会发布的诊断标准;采用TaqMan 实时荧光定量PCR技术检测血清miR-133a水平;同时分析其血脂、心肌损伤指标及冠状动脉疾病Gensini积分;采用ROC曲线分析计算曲线下面积(AUC)及其95%置信区间(CI),多项Logistic回归分析计算风险比(OR)值及其95% CI。结果与健康对照者[ΔCt:1.00±0.05]相比,ACS[ΔCt:2.34±0.24](t =6.059, P<0.001)和SCAD[ΔCt:1.45±0.13](t=3.265, P=0.001)患者血清miR-133a水平均显著升高,且ACS患者miR-133a水平显著高于SCAD患者(t=3.133, P=0.002)。相关性分析显示,ACS和SCAD患者血清miR-133a水平与心肌型肌酸激酶同工酶(CK-MB)(r=0.402, P<0.001)、肌钙蛋白I (cTNI)(r=0.410, P=0.001)及Gensini积分(r=0.438, P<0.001)呈正相关。 ROC曲线分析显示,血清miR-133a区分冠状动脉疾病(CAD)患者与健康对照者的AUC为0.717(95% CI:0.645~0.788, P<0.001);区分ACS与SCAD患者的AUC为0.667(95%CI:0.573~0.761, P=0.001)。 Logistic回归分析显示,在校正了年龄、性别及血脂水平的影响后,血清miR-133a水平的升高与ACS ( OR=6.00,95%CI:1.93~18.67, P=0.002)、SCAD (OR=2.81,95% CI:1.03~7.68, P=0.044)的发生相关,且对ACS、SCAD 的区分具有显著意义( OR =2.13,95% CI:1.20~3.78, P =0.010)。结论CAD患者血清miR-133a水平显著升高,且ACS患者的水平变化较SCAD患者更为显著;血清miR-133a可能是CAD病情评估与判断的潜在标志物。(中华检验医学杂志,2015,38:686-690)
目的:探討急性冠狀動脈綜閤徵(ACS)和穩定性冠狀動脈性心髒病(SCAD)患者血清miR-133a的水平變化及臨床價值。方法迴顧性研究。選取2011年10月至2012年10月期間南京軍區南京總醫院住院的64例ACS、62例SCAD患者及70名常規體檢的健康對照者,其中ACS和SCAD根據歐洲心髒病學會髮佈的診斷標準;採用TaqMan 實時熒光定量PCR技術檢測血清miR-133a水平;同時分析其血脂、心肌損傷指標及冠狀動脈疾病Gensini積分;採用ROC麯線分析計算麯線下麵積(AUC)及其95%置信區間(CI),多項Logistic迴歸分析計算風險比(OR)值及其95% CI。結果與健康對照者[ΔCt:1.00±0.05]相比,ACS[ΔCt:2.34±0.24](t =6.059, P<0.001)和SCAD[ΔCt:1.45±0.13](t=3.265, P=0.001)患者血清miR-133a水平均顯著升高,且ACS患者miR-133a水平顯著高于SCAD患者(t=3.133, P=0.002)。相關性分析顯示,ACS和SCAD患者血清miR-133a水平與心肌型肌痠激酶同工酶(CK-MB)(r=0.402, P<0.001)、肌鈣蛋白I (cTNI)(r=0.410, P=0.001)及Gensini積分(r=0.438, P<0.001)呈正相關。 ROC麯線分析顯示,血清miR-133a區分冠狀動脈疾病(CAD)患者與健康對照者的AUC為0.717(95% CI:0.645~0.788, P<0.001);區分ACS與SCAD患者的AUC為0.667(95%CI:0.573~0.761, P=0.001)。 Logistic迴歸分析顯示,在校正瞭年齡、性彆及血脂水平的影響後,血清miR-133a水平的升高與ACS ( OR=6.00,95%CI:1.93~18.67, P=0.002)、SCAD (OR=2.81,95% CI:1.03~7.68, P=0.044)的髮生相關,且對ACS、SCAD 的區分具有顯著意義( OR =2.13,95% CI:1.20~3.78, P =0.010)。結論CAD患者血清miR-133a水平顯著升高,且ACS患者的水平變化較SCAD患者更為顯著;血清miR-133a可能是CAD病情評估與判斷的潛在標誌物。(中華檢驗醫學雜誌,2015,38:686-690)
목적:탐토급성관상동맥종합정(ACS)화은정성관상동맥성심장병(SCAD)환자혈청miR-133a적수평변화급림상개치。방법회고성연구。선취2011년10월지2012년10월기간남경군구남경총의원주원적64례ACS、62례SCAD환자급70명상규체검적건강대조자,기중ACS화SCAD근거구주심장병학회발포적진단표준;채용TaqMan 실시형광정량PCR기술검측혈청miR-133a수평;동시분석기혈지、심기손상지표급관상동맥질병Gensini적분;채용ROC곡선분석계산곡선하면적(AUC)급기95%치신구간(CI),다항Logistic회귀분석계산풍험비(OR)치급기95% CI。결과여건강대조자[ΔCt:1.00±0.05]상비,ACS[ΔCt:2.34±0.24](t =6.059, P<0.001)화SCAD[ΔCt:1.45±0.13](t=3.265, P=0.001)환자혈청miR-133a수평균현저승고,차ACS환자miR-133a수평현저고우SCAD환자(t=3.133, P=0.002)。상관성분석현시,ACS화SCAD환자혈청miR-133a수평여심기형기산격매동공매(CK-MB)(r=0.402, P<0.001)、기개단백I (cTNI)(r=0.410, P=0.001)급Gensini적분(r=0.438, P<0.001)정정상관。 ROC곡선분석현시,혈청miR-133a구분관상동맥질병(CAD)환자여건강대조자적AUC위0.717(95% CI:0.645~0.788, P<0.001);구분ACS여SCAD환자적AUC위0.667(95%CI:0.573~0.761, P=0.001)。 Logistic회귀분석현시,재교정료년령、성별급혈지수평적영향후,혈청miR-133a수평적승고여ACS ( OR=6.00,95%CI:1.93~18.67, P=0.002)、SCAD (OR=2.81,95% CI:1.03~7.68, P=0.044)적발생상관,차대ACS、SCAD 적구분구유현저의의( OR =2.13,95% CI:1.20~3.78, P =0.010)。결론CAD환자혈청miR-133a수평현저승고,차ACS환자적수평변화교SCAD환자경위현저;혈청miR-133a가능시CAD병정평고여판단적잠재표지물。(중화검험의학잡지,2015,38:686-690)
Objective To investigate altered levels and clinical significance of serum miR-133a in patients with acute coronary syndrome ( ACS ) and stable coronary artery disease ( SCAD ) .Methods Retrospective study.Serum miR-133a levels were determined by TaqMan quantitative reverse-transcription PCR assay in 64 ACS, 62 SCAD patients who were admitted to Jinling Hospital from October 2011 to October 2012 and 70 normal controls who had contemporaneously visited Jinling Hospital for routine examination .The ACS and SCAD patients were diagnosed according to the European Society of Cardiology guidelines .Serum lipid/lipoprotein profiles , myonecrosis biomarkers and Gensini scores were also analyzed .The area under curve ( AUC) and 95%confidence interval ( CI) were calculated using ROC analyses .The odds ratio ( OR) and 95%CI were calculated using the multivariate logistic regression analyses .Results Compared with the controls [ΔCt:1.00 ±0.05], serum miR-133a levels were significantly increased in both ACS [ΔCt:2.34 ±0.24] (t=6.059, P<0.001) and SCAD [ΔCt:1.45 ±0.13] (t=3.265, P=0.001) patients.The miR-133a levels in ACS patients were significantly higher than in SCAD patients (t=3.133, P=0.002). Serum miR-133a were positively correlated with levels of creatine kinase MB ( CK-MB) ( r=0.402, P<0.001), cardiac troponin I (cTNI) (r=0.410, P=0.001) and Gensini scores (r=0.438, P<0.001). ROC curve analyses showed that the AUC of miR-133a for differentiating coronary artery disease (CAD) and controls was 0.717 (95%CI:0.645-0.788, P<0.001) and the AUC for differentiating ACS and SCAD was 0.667 (95% CI:0.573-0.761, P=0.001).Logistic regression analyses revealed that high miR-133a levels were closely associated with the presence of ACS ( OR=6.00, 95% CI:1.93 -18.67, P=0.002) and SCAD (OR=2.81, 95%CI:1.03-7.68, P=0.044), and also had statistical significance for differentiating ACS and SCAD (OR=2.13, 95% CI:1.20-3.78, P=0.010), after adjustment for the age, gender and serum lipid/lipoprotein levels.Conclusions Serum miR-133a levels were significantly elevated in CAD patients, and ACS patients exhibited the more significant increase .Serum miR-133a may be function as the potential biomarker for the disease assessment and judgement .