摘要目的 评估血浆microRNA-1(miR-1)在早期诊断急性心肌梗死(AMI,acute myocardial infarction)中的价值,并与肌钙蛋白T(cardiac troponin T,cTnT)进行比较分析.方法 收集2011年5月至2012年5月间的56名AMI患者和28名无AMI的对照者的血浆标本,通过实时定量逆转录聚合酶链反应(quantitative reverse transcription-polymerase chain reaction,qRT-PCR)检测血浆中miR-1的含量,同时通过电化学发光法检测血浆cTnT的变化.对所得数据应用SPSS 16.0软件包进行分析.AMI与对照组病例的临床特征数据的比较采用t检验或Fisher's检验.MicroRNA在AMI和对照病例间表达的差异运用Mann-Whitney检验.AMI病例不同时间点间血浆microRNA表达差异的两两比较采用Wilcoxon检验.受试者工作特征曲线(receiver operating characteristic curve,ROC)用于分析AMI病例与对照组间的差异.结果 AMI患者血浆中miR-1的含量较对照组明显升高(P＜0.01),AMI患者14 d时miR-1的含量已回落到基线水平.血浆miR-1值的变化与研究对象的自身特征无相关性(P＞0.05).同时,通过ROC曲线分析,笔者发现miR-1具有早期诊断AMI的特异性和敏感性,但并不优于hs-cTnT.结论 血浆miR-1在早期诊断AMI方面具有明确的心肌特异性和敏感性,可作为AMI诊断的生物学标志物,但其诊断价值并不优于cTnT.

abstractsObjective To detect the level of plasma microRNA-1 (miR-1) in acute myocardial infarction (AMI) and compare the diagnostic values of it with that of cardiac troponin T (cTnT).Methods During 2011-05 to 2012-05,there were fifty-six plasma samples taken from patients with AMI and twenty-eight plasma specimens got from non-AMI controls were analyzed.The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR),and the level of plasma cTnT was measured by using electrochemiluminescence-based methods on the Elecsys 2010 Immunoassay Analyzer.Then,the SPSS 16.0 was used for the statistical analysis.Data were presented as means ± standard deviation unless otherwise described.The differences about clinical characteristics between AMI patients and controls were tested using Student' s t-test or Fisher' s exact test.The Mann-Whitney test was conducted to compare the expression of microRNAs between the AMI patients and controls.The comparison of microRNAs expression between different intervals of AMI patients was done using Wilcoxon signed rank test.The receiver operating characteristic (ROC) curve was established to discriminate AMI patients from controls.Results The expression of plasma miR-1 was significantly increased in AMI patients (P ＜ 0.01) compared with healthy controls.The contents of the plasma miR-1 in AMI patients fell down nearly to the normal level at 14 days (P ＞ 0.05).There was no relevance between the expression of plasma miR-1 and the clinical characteristics of the study population (P ＞ 0.05).Moreover,ROC curve analyses demonstrated that miR-1 had the specificity and sensitivity for the diagnosis of early AMI,but was not superior to cTnT.Conclusions Our results showed that plasma miR-1 had the capacity in early diagnosis of early AMI,and can be biomarker for AMI,however,miR-1 is not superior to cTnT for the diagnosis of AMI.