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脓毒症致心肌损伤患儿血浆miRNA-497的表达及其临床意义

[Expression of plasma miRNA-497 in children with sepsis-induced myocardial injury and its clinical significance].

作者信息

Wu Zhong-Jing, Chen Ya-Feng, Wang Hai-Dao, Gao Fang-Hong

机构信息

Department of Clinical Laboratory, Haikou Maternal and Child Health Care Hospital, Haikou 570102, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jan;20(1):32-36. doi: 10.7499/j.issn.1008-8830.2018.01.007.

Abstract

OBJECTIVE

To study the expression of plasma miRNA-497 in children with sepsis-induced myocardial injury and its clinical significance.

METHODS

A total of 148 children with sepsis were enrolled. According to the presence or absence of myocardial injury, these children were divided into myocardial injury group (n=58) and non-myocardial injury group (n=90). The two groups were compared in terms of the changes in plasma levels of miRNA-497, cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), procalcitonin (PCT), and C-reactive protein (CRP) and left ventricular ejection fraction (LVEF). The receiver operating characteristic (ROC) curve was plotted to evaluate the value of plasma miRNA-497, cTnI, and CK-MB in the diagnosis of myocardial injury. A Pearson correlation analysis was used to determine the correlation of miRNA-497 with cTnI, CK-MB, NT-proBNP, PCT, CRP, and LVEF.

RESULTS

Compared with the non-myocardial injury group, the myocardial injury group had significantly higher plasma levels of miRNA-497, cTnI, CK-MB, NT-proBNP, PCT, and CRP (P<0.05). Plasma miRNA-497, cTnI, and CK-MB when measured alone or in combination had an area under the ROC curve of 0.918, 0.931, 0.775, and 0.940 respectively. At the optimal cut-off value of 2.05, miRNA-497 had a sensitivity of 90.4% and a specificity of 91.2%. The correlation analysis showed that there was a good correlation between plasma miRNA-497 and cTnI in children with myocardial injury (r=0.728, P<0.01).

CONCLUSIONS

Plasma miRNA-497 has a similar value as cTnI in the diagnosis of sepsis-induced myocardial injury in children and may be used as a potential marker for early diagnosis of myocardial injury.

摘要

目的

研究血浆微小RNA-497在脓毒症诱导的心肌损伤患儿中的表达及其临床意义。

方法

共纳入148例脓毒症患儿。根据是否存在心肌损伤,将这些患儿分为心肌损伤组(n = 58)和非心肌损伤组(n = 90)。比较两组患儿血浆微小RNA-497、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶MB(CK-MB)、N末端脑钠肽前体(NT-proBNP)、降钙素原(PCT)、C反应蛋白(CRP)水平变化及左心室射血分数(LVEF)。绘制受试者工作特征(ROC)曲线,评估血浆微小RNA-497、cTnI和CK-MB对心肌损伤的诊断价值。采用Pearson相关分析确定微小RNA-497与cTnI、CK-MB、NT-proBNP、PCT、CRP及LVEF的相关性。

结果

与非心肌损伤组相比,心肌损伤组患儿血浆微小RNA-497、cTnI、CK-MB、NT-proBNP、PCT和CRP水平显著升高(P < 0.05)。单独或联合检测时,血浆微小RNA-497、cTnI和CK-MB的ROC曲线下面积分别为0.918、0.931、0.775和0.940。在最佳截断值为2.05时,微小RNA-497的灵敏度为90.4%,特异度为91.2%。相关性分析显示,心肌损伤患儿血浆微小RNA-497与cTnI之间存在良好相关性(r = 0.728,P < 0.01)。

结论

血浆微小RNA-497在儿童脓毒症诱导的心肌损伤诊断中与cTnI具有相似价值,可能作为心肌损伤早期诊断的潜在标志物。

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