miR-26a-5p和miR-708-3p对急性胸痛病因急性心肌梗死的诊断价值OA
The Diagnostic Value of miR-26a-5p and miR-708-3p for Acute Myocardial Infarction Among Etiologies of Acute Chest Pain
目的 探讨血清miR-26a-5p和miR-708-3p对急性胸痛(ACP)病因急性心肌梗死(AMI)中的诊断价值.方法 前瞻性选取2022年1月至2024年12月因ACP于石家庄市人民医院急诊科就诊,经相关检查确诊为AMI、急性肺栓塞(APE)、急性主动脉夹层(AAD)患者共237例作为ACP组,根据病因将其分为AMI患者(159例)和APE+AAD患者(78例),根据HEART评分分为中高危胸痛患者(172例)和低危胸痛患者(65例);另选取同期于本院体检的健康者172例为对照组.采用实时荧光定量反转录聚合酶链反应法检测对照组体检当日,ACP组入院后1 h的血清miR-26a-5p、miR-708-3p水平;采用ROC曲线评估血清miR-26a-5p、miR-708-3p对ACP病因AMI的诊断价值.结果 ACP组血清miR-26a-5p(0.64±0.20)、miR-708-3p(0.68±0.11)水平显著低于对照组(1.01±0.12、1.02±0.08),差异有统计学意义(P<0.001);中高危胸痛患者血清miR-26a-5p、miR-708-3p水平显著低于低危胸痛患者(P<0.001);AMI患者血清D-二聚体、N末端型钠尿肽前体、miR-26a-5p、miR-708-3p水平显著低于APE+AAD患者,hs-cTnI水平显著高于APE+AAD患者(P<0.001);血清miR-26a-5p、miR-708-3p对ACP病因AMI诊断的曲线下面积分别为0.824、0.837,两者联合对ACP病因AMI诊断的曲线下面积为0.903,两者联合预测优于单独指标预测(P<0.05).结论 ACP患者血清miR-26a-5p、miR-708-3p水平显著降低,两者联合对ACP病因AMI的诊断价值较高.
Objective To investigate the clinical value of serum microRNA-26a-5p(miR-26a-5p)and microRNA-708-3p(miR-708-3p)in acute myocardial infarction(AMI)in patients with acute chest pain(ACP).Methods A total of 237 patients who presented to the emergency department of Shijiazhuang People's Hospital with ACP from January 2022 to December 2024 and were diagnosed with AMI,acute pulmonary embolism(APE),or acute aortic dissection(AAD)by relevant examinations were prospectively enrolled as the ACP group.According to etiology,they were divided into AMI patients(n=159)and APE+AAD patients(n=78);according to the HEART score,they were divided into intermediate-to high-risk chest pain patients(n=172)and low-risk chest pain patients(n=65).Meanwhile,172 healthy individuals who underwent physical examination at our hospital during the same period were selected as the control group.Quantitative real-time reverse transcription polymerase chain reaction was used to detect serum levels of miR-26a-5p and miR-708-3p in the control group on the day of physical examination and in the ACP group at 1 h after admission.ROC curve analysis was performed to evaluate the diagnostic value of serum miR-26a-5p and miR-708-3p for AMI among etiologies of ACP.Results Serum levels of miR-26a-5p(0.64 ± 0.20)and miR-708-3p(0.68 ± 0.11)in the ACP group were significantly lower than those in the control group(1.01 ± 0.12 and 1.02 ± 0.08,respectively),with statistically significant differences(P<0.001).Serum levels of miR-26a-5p and miR-708-3p in patients with intermediate-to high-risk chest pain were significantly lower than those in patients with low-risk chest pain(P<0.001).Serum levels of D-dimer,NT-proBNP,miR-26a-5p,and miR-708-3p in AMI patients were significantly lower,while the level of hs-cTnI was significantly higher,than those in patients with APE+AAD(all P<0.001).The AUC of serum miR-26a-5p and miR-708-3p for the diagnosis of AMI as the etiology of ACP were 0.824 and 0.837,respectively.The combined AUC of the two miRNAs was 0.903,and their combined prediction was superior to individual prediction(P<0.05).Conclusion Serum miR-26a-5p and miR-708-3p were significantly decreased in patients with ACP,and the combination of the two had a high diagnostic value for AMI in the etiology of ACP.
宋博超;朱磊;熊敏;王昊;刘星;穆东;陈浩;李世超
石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000石家庄市人民医院心血管内科,石家庄 050000邢台市中心医院心内科,河北 邢台 054000
微小RNA-26a-5p微小RNA-708-3p急性胸痛急性心肌梗死急性肺栓塞
microRNA-26a-5pmicroRNA-708-3pacute chest painacute myocardial infarctionacute pulmonary embolism
《转化医学杂志》 2026 (8)
1285-1289,5
2025年度河北省医学科学研究课题计划项目(20251419)石家庄市科学技术研究与发展计划项目(211460383)
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