| 魏丹,金晶,柳梅,赵娟.血清miR-21-3p表达对脓毒症心肌损伤的早期诊断价值.[J].中南医学科学杂志.,2021,(6):648-651. |
| 血清miR-21-3p表达对脓毒症心肌损伤的早期诊断价值 |
| The value of serum miR-21-3p expression in the early diagnosis of myocardial injury in sepsis |
| 投稿时间：2020-12-02 修订日期：2021-08-25 |
| DOI：10.15972/j.cnki.43-1509/r.2021.06.007 |
| 中文关键词: miR-21-3p 脓毒症 心肌损伤 超声心动图 |
| 英文关键词:miR-21-3p sepsis myocardial injury echocardiography |
| 基金项目:湖北省自然科学基金项目(2018CFB353)；武汉市中青年医学骨干人才项目(2018[116]) 作者简介:魏丹,硕士,主治医师,研究方向为心力衰竭,E-mail为weidan2000@163.com。通信作者赵娟,硕士,主治医师,研究方向为心力衰竭,E-mail为cocosignal@163.com。 |
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| 中文摘要: |
| 目的探讨血清miR-21-3p表达对脓毒症心肌病的早期诊断价值。方法96例脓毒症患者按有无心肌损伤分为脓毒症组(59例)和心肌损伤组(37例)。比较两组肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌红蛋白(Myo)、N末端B型脑钠肽前体(NT-proBNP)和miR-21-3p水平。超声心动图测定并比较两组左心室收缩期末内径(LVESD)、左心室舒张期末内径(LVEDD)、左心室射血分数(LVEF)、二尖瓣口舒张早期最大流速(E)与心房收缩期最大流速(A)比值(E/A)、二尖瓣舒张早期血流峰速度(E)与二尖瓣环舒张早期运动峰速度(e′)比值(E/e′)等指标。受试者工作特征(ROC)曲线评估miR-21-3p早期诊断价值。结果入院即刻心肌损伤组miR-21-3p明显高于脓毒症组(P＜0.05)。入院3 h,心肌损伤组cTnI、Myo、miR-21-3p明显高于脓毒症组(P＜0.05)；心肌损伤组miR-21-3p与cTnI呈明显正相关。入院3 h,miR-21-3p诊断脓毒症心肌损伤的ROC曲线下面积0.904,灵敏度86.1%,特异度84.7%。入院6 h和12 h,心肌损伤组cTnI、CK-MB、Myo、NT-proBNP和miR-21-3p均明显高于脓毒症组(P＜0.05)。入院12 h,心肌损伤组LVESD、LVEDD、E/e′明显高于脓毒症组(P＜0.05),LVEF、E/A明显低于脓毒症组(P＜0.05),miR-21-3p与LVEF呈明显负相关。结论血清miR-21-3p表达有助于早期诊断脓毒症心肌病。 |
| 英文摘要: |
| To investigate the value of serum miR-21-3p expression in the early diagnosis of myocardial injury in sepsis. Methods96 patients with sepsis were divided into sepsis group (n＝59) and myocardial injury group (n＝37)according to whether there was myocardial injury. The levels of serum cardiac troponin I(cTnI), creatine kinase-MB(CK-MB), myoglobin(Myo), N-terminal pro-B type natriuretic peptide(NT-proBNP), and miR-21-3p were compared between two groups. The left ventricular end systolic diameter (LVESD), the left ventricular end diastolic diameter (LVEDD), the left ventricular ejection fraction (LVEF), the early diastolic blood flow velocity of mitral valve orifice(E)/the late diastolic blood flow velocity of mitral valve orifice (A), the early diastolic blood flow velocity of mitral valve orifice(E)/the early diastolic average velocity of mitral valve ring (e′)were compared by echocardiography. The diagnostic value of the level of serum miR-21-3p was analyzed by ROC curve. ResultsAt the time of admission, miR-21-3p in myocardial injury group was significantly higher than that in sepsis group(P＜0.05). Three hours after admission, the levels of cTnI, Myo, miR-21-3p in myocardial injury group were significantly higher compared with sepsis group(P＜0.05). There was a significant positive correlation between serum miR-21-3p and cTnI in myocardial injury group. The area under the ROC curve of miR-21-3p at 3 h for the diagnosis of myocardial injury in sepsis was 0.904, the sensitivity was 86.1%, and the specificity was 84.7%. The levels of CTnI, CK-MB, Myo, NT-proBNP,and miR-21-3p in myocardial injury group were significantly higher than those in sepsis group at 6 h and 12 h after admission(P＜0.05). LVESD, LVEDD and E/E′ in myocardial injury group were significantly higher than those in sepsis group(P＜0.05), and LVEF and E/A were significantly lower than those in sepsis group at 12 h after admission(P＜0.05). miR-21-3p was significantly negatively correlated with LVEF. ConclusionThe level of serum miR-21-3p is helpful for the early diagnosis of myocardial injury in sepsis. |
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