血浆miRNA-190 及miRNA-197联合检测可辅助诊断肺血栓栓塞症
Combined detection of miRNA-190 and miRNA-197 is conducive to the diagnosis of pulmonary thromboembolism

周晓婷.血浆miRNA-190 及miRNA-197联合检测可辅助诊断肺血栓栓塞症[J].内科急危重症杂志,2021,27(5):397-400

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DOI：10.11768/nkjwzzzz20210510

中文关键词: 肺血栓栓塞血浆miRNA-190 血浆miRNA-197 联合诊断

英文关键词:

基金项目:苏州市第九人民医院科研基金项目（院201726、YK202109）

作者	单位	E-mail
周晓婷	苏州市第九人民医院呼吸与危重症医学科	cx_shishi@163.com

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中文摘要:

目的：探讨血浆miRNA-190和miRNA-197在肺血栓栓塞症（PTE）患者中表达水平及辅助诊断价值。方法：选择2017年7月至2019年6月苏州市第九人民医院PTE患者30例为PTE组，同期匹配心肌梗死患者45例为心肌梗死组，健康体检者45例为正常对照组。采用实时荧光定量PCR（qRT-PCR）检测血浆miRNA-190和miRNA-197在所有受试者外周血中的表达水平，并分析其在3组中的表达量差异。应用受试者工作特征曲线(ROC曲线)及曲线下面积（AUC）（95% CI ）评估两者单独或联合检测作为PTE诊断指标的意义。结果：血浆miRNA-190在3组中的相对表达量分别为3.01±2.01，1.80±1.02，1.18±0.67；其在PTE组血浆中表达量较心肌梗死组及正常对照组高( t =3.602， t = 5.814, P 均＜0.05)。血浆miRNA-197在3组中相对表达量分别为4.82±3.80，1.88±1.50， 1.38±0.83；其在PTE组血浆中表达量较心肌梗死组及正常对照组高( t =4.791, t =5.886， P 均＜ 0.05)。作为PTE的诊断指标，血浆miRNA-190的最佳临界值为1.598，敏感度为75.56%，特异度为80.00%，AUC为0.7844，95% CI 为0.6858～0.8831；血浆miRNA-197最佳临界值为2.40，敏感度为75.56%，特异度为 86.67%，AUC为0.7931，95% CI 为0.6870～0.8991。血浆miRNA190和miRNA-197联合检测诊断PTE的敏感度为80.00%，特异度为93.33%，AUC为0.9136，95% CI 为 0.8516～0.9756；均高于两者单独检测。结论：血浆miRNA-190和miRNA-197在PTE患者外周血血浆中表达量明显升高，两者联合检测敏感度和特异度更高，有助于PTE的辅助诊断。

英文摘要:

Objective: To study the diagnostic value of quantitative detection of plasma miRNA-190 and miRNA-197 in patients with pulmonary thromboembolism (PTE). Methods: Totally, 30 patients diagnosed with PTE admitted to Respiratory Medicine of Suzhou Ninth People's Hospital from July 2017 to June 2019 were enrolled in this study and plasma was collected. A total of 45 patients with myocardial infarction (MCI) and 45 healthy participants were recruited as the control group. qRT-PCR was used to detect the relative expression level of miRNA-190 and miRNA-197. The diagnostic value was evaluated by receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) (95%CI). Results: The plasma level of miRNA-190 in PTE group, MCI group and healthy group was 3.01±2.01, 1.80±1.02 and 1.18±0.67 respectively. The plasma level of miRNA-190 in PTE group was significantly higher than in MCI group and healthy group (t=3.602, t=5.814, P all< 0.0001). The plasma level of miRNA-197 in PTE group, MCI group and healthy group was 4.82±3.80, 1.88±1.50, 1.38±0.83 respectively, and the relative expression of miRNA-197 in PTE group was significantly higher than that in the other two groups (t=4.791, t=5.886, P all<0.05). As the diagnostic indicator, the sensitivity and specificity of miRNA-190 were 75.56% and 80% respectively, with the AUC being 0.7844 (95%CI: 0.6858-0.8831). The sensitivity and specificity of miRNA-197 was 75.56% and 86.67% and the AUC was 0.7931 (95%CI: 0.6870-0.8991). However, the combined detection of miRNA-190 and miRNA-197 showed the sensitivity and specificity of 80.00% and 93.33% respectively, and the AUC was 0.9136 (95%CI: 0.8516-0.9756). Conclusion: The relative expressions of miRNA-190 and miRNA-197 in PTE patients were significantly higher than those in MCI group and healthy group. Combined detection of miRNA-190 and miRNA-197 shows higher sensitivity and specificity, which is more conducive to the diagnosis of PTE.