| 摘要: |
| ［摘要］ 目的 分析急性冠脉综合征（ACS）患者血清miR-139-5p表达水平与短期预后的关联性。方法 招募2021年1月至2021年9月安徽省第二人民医院收治的因胸痛入院的ACS患者176例，其中不稳定型心绞痛(UAP)患者100例（UAP组）、急性心肌梗死(AMI)患者76例（AMI组）。另选择同期因胸痛入院，并经冠脉造影检查排除冠心病的28例患者为对照组。于患者入院次日抽静脉血检测血清miR-139-5p和血管内皮细胞生长因子受体-1（VEGFR-1）表达水平，并收集患者其他临床资料。对所有患者进行6个月随访，记录其主要心血管不良事件（MACE）发生情况。结果 与对照组比较，UAP组和AMI组血清miR-139-5p表达水平更高，VEGFR-1表达水平更低，差异有统计学意义（P<0.05）。且AMI组血清miR-139-5p表达水平较UAP组显著升高（P<0.05），但两组血清VEGFR-1表达水平比较差异无统计学意义（P>0.05）。Pearson相关性分析结果显示，ACS患者血清miR-139-5p表达水平与VEGFR-1表达水平呈负相关（r=-0.189，P=0.010）。Cox回归分析结果显示，较高的血清miR-139-5p表达水平是促进MACE发生的危险因素（P<0.05）。受试者工作特征（ROC）曲线分析结果显示，血清miR-139-5p表达水平能有效预测术后MACE发生［AUC(95%CI)=0.81(0.73～0.89)，P<0.001］，其最佳截断值为2.08，对应的灵敏度为82.83%，特异度为66.28%。K-M曲线分析结果显示，血清miR-139-5p表达水平≥2.08的ACS患者的无MACE生存时间较血清miR-139-5p表达水平<2.08者更短，差异有统计学意义（P<0.001）。结论 ACS患者具有较高的血清miR-139-5p表达水平，血清miR-139-5p表达水平≥2.08时提示患者发生MACE的风险较大，应引起临床医师关注。 |
| 关键词: 急性冠脉综合征 miR-139-5p 主要心血管不良事件 短期预后 |
| DOI：10.3969/j.issn.1674-3806.2023.07.13 |
| 分类号:R 543.3 |
| 基金项目:国家自然科学基金面上项目（编号：81970313）；安徽医科大学科研基金资助项目（编号：2021xkj125，2021xkj117）；安徽省临床重点专科建设项目 |
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| Analysis of the correlation between serum miR-139-5p expression level and short-term prognosis in patients with acute coronary syndrome |
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GAO Yan-lin, CHENG Wei, ZHU Meng-yu, et al.
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Department of Cardiology, Anhui No.2 Provincial People′s Hospital, Hefei 230000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the correlation between serum miR-139-5p expression level and the short-term prognosis in patients with acute coronary syndrome(ACS). Methods One hundred and seventy-six ACS patients who were admitted to Anhui No.2 Provincial People′s Hospital due to chest pain from January 2021 to September 2021 were recruited, including 100 patients with unstable angina pectoris(UAP)(UAP group) and 76 patients with acute myocardial infarction(AMI)(AMI group). Other 28 patients who were admitted to the hospital due to chest pain and were excluded from coronary heart disease by coronary angiography were selected as control group. On the next day of admission, the venous blood of the patients was drawn to detect the expression levels of serum miR-139-5p and vascular endothelial growth factor receptor-1(VEGFR-1), and the other clinical data of the patients were collected. All the patients were followed up for 6 months to record the occurrence of major adverse cardiovascular events(MACE). Results Compared with the control group, the UAP group and the AMI group had higher serum expression levels of miR-139-5p and lower serum expression levels of VEGFR-1, and the differences were statistically significant(P<0.05). The serum expression level of miR-139-5p in the AMI group was significantly higher than that in the UAP group(P<0.05), but there was no significant difference in the serum expression level of VEGFR-1 between the two groups(P>0.05). The results of Pearson correlation analysis showed that the serum expression level of miR-139-5p in the ACS patients was negatively correlated with the expression level of VEGFR-1(r=-0.189, P=0.010). The results of Cox regression analysis showed that higher serum expression level of miR-139-5p was a risk factor for MACE development(P<0.05). The results of receiver operating characteristic(ROC) curve analysis showed that the serum expression level of miR-139-5p could effectively predict the occurrence of postoperative MACE ［AUC(95%CI)=0.81(0.73-0.89), P<0.001］, and its optimal cut-off value was 2.08, and the corresponding sensitivity and specificity were 82.83% and 66.28%, respectively. The results of K-M curve analysis showed that the free-MACE survival time of the ACS patients with serum expression level of miR-139-5p≥2.08 was shorter than that of the ACS patients with serum expression level of miR-139-5P<2.08, and the difference was statistically significant(P<0.001). Conclusion Patients with ACS have a relatively high expression level of serum miR-139-5p, and when the expression level of serum miR-139-5p≥2.08, it indicates that the patients are at a greater risk of developing MACE, which should be concerned by clinicians. |
| Key words: Acute coronary syndrome(ACS) miR-139-5p Major adverse cardiovascular events(MACE) Short-term prognosis |
