探究miR-374a-5p与急性ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的关系

doi:10.3760/cma.j.issn.1007-1245.2023.12.012

摘要/Abstract

摘要：

目的　探究与分析miR-374a-5p与急性ST段抬高型心肌梗死患者经皮冠状动脉介入术（PCI）后6个月内支架内血栓形成的关系。方法　回顾性分析晋城市人民医院2020年4月至2022年3月收治的实施PCI治疗的急性ST段抬高型心肌梗死患者138例的临床资料，按照术后6个月是否出现了支架内血栓形成分为形成组（27例）及未形成组（111例），查阅患者的临床基线资料以及实验室检查指标等，采用单因素及多因素logistic回归分析ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的影响因素；采用受试者工作特征曲线（ROC）分析miR-374a-5p在判断ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的价值。结果　形成组性别、年龄、体质量指数（BMI）、高血压病史、高血脂病史、梗死部位、急诊PCI时间、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、收缩压（SBP）、舒张压（DBP）、血红蛋白（Hb）、血小板计数（PLT）、心率（HR）及左心室射血分数（LVEF）与未形成组相比，差异均无统计学意义（均P>0.05）。与未形成组相比，形成组糖尿病病史比例、多支架置入比例、血清miR-374a-5p水平较高，差异均有统计学意义（均P<0.05）。ROC下面积为0.699，标准误差为0.049，显著性为<0.001，渐进95%置信区间为0.604～0.795，该组患者实施PCI后6个月内发生支架内血栓形成的miR-374a-5p切点为1.115，提示miR-374a-5p具有较好的诊断价值。行logistic回归分析发现，糖尿病病史、多支架置入以及miR-374a-5p可作为ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的高危因素（均P<0.05）。结论　糖尿病病史、多支架置入以及miR-374a-5p可作为ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的高危因素。检测miR-374a-5p水平可辅助评估ST段抬高型心肌梗死患者的预后。

关键词:

ST段抬高型心肌梗死, miR-374a-5p, 经皮冠状动脉介入术, 血栓形成, 预后

Abstract:

Objective　To explore and analyze the relationship between miR-374a-5p and intrastent thrombosis within 6 months after percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction. Methods　The clinical data of 138 patients with ST-segment elevation myocardial infarction treated by PCI at Jincheng People's Hospital from April 2020 to March 2022 were retrospectively analyzed. According to whether intrastent thrombosis occurred 6 months after the surgery, the patients were divided into a formation group (27 cases) and a non-formed group (111 cases). All the clinical baseline data and laboratory examination indicators were reviewed. The univariate and multivariate logistic regressions were used to analyze the factors of intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. The receiver operating characteristic curve (ROC) was used to analyze the value of miR-374a-5p in determining the intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. Results　There were no statistical differences in the gender, age, body mass index (BMI), history of hypertension, history of hyperlipidemia, site of infarction, emergency PCI time, total cholesterol (TC), triacylglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), platelet count (PLT), heart rate (HR), and left ventricular ejection fraction (LVEF) between the formation group and the non-formed group (all P>0.05). The proportions of the patients with diabetes history and multiple stentings and the serum miR-374a-5p level in the formation group were higher than those in the non-formed group, with statistical differences (all P<0.05). The area under the ROC was 0.699; the standard error was 0.049; the significance was <0.001; the progressive 95% confidence interval was 0.604-0.795; the miR-374a-5p cut-off point of intrastent thrombosis within 6 months after PCI surgery in the patients was 1.115, indicating that miR-374a-5p had good diagnostic value. Logistic regression analysis showed that history of diabetes, multiple stentings, and miR-374a-5p could be used as risk factors for intrastent thrombosis within 6 months after PCI in the patients with ST-segment elevation myocardial infarction (all P<0.05). Conclusions History of diabetes, multiple stentings, and miR-374a-5p can be used as risk factors for inrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction. The detection of miR-374a-5p level can evaluate the prognosis of patients with ST-segment elevation myocardial infarction.

Key words:

ST-segment elevation myocardial infarction, MiR-374a-5p, Percutaneous coronary intervention, Thrombosis, Prognosis

李晶周晶潘三葱.

探究miR-374a-5p与急性ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的关系 [J]. 国际医药卫生导报, 2023, 29(12): 1678-1682.

Li Jing, Zhou Jing, Pan Sancong.

Relationship between miR-374a-5p and intrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction [J]. International Medicine and Health Guidance News, 2023, 29(12): 1678-1682.

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