| 摘要: |
| ［摘要］ 目的 探讨斑点追踪超声心动图（STE）联合血浆miR-30a评估急性冠状动脉综合征（ACS）患者近期预后的效能，为指导临床治疗提供参考。方法 选择2020年1月至2020年12月在华南理工大学附属第六医院收治的ACS患者252例，均对病变冠脉行完全血运重建。根据患者起病1个月后的预后情况将其分为预后良好组（199例）和预后不良组（53例）。应用STE检测左心室整体纵向应变（LV-GLS）和左心室射血分数（LVEF）。应用real-time PCR法检测血浆miR-30a水平。采用多因素logistic回归分析LV-GLS和血浆miR-30a指标对ACS患者近期预后的影响，采用ROC曲线法分析LV-GLS和血浆miR-30a指标评估ACS患者近期预后的效能。结果 预后良好组LV-GLS低于预后不良组，血浆miR-30a相对表达量低于预后不良组，差异有统计学意义（P<0.05），但两组LVEF指标比较差异无统计学意义（P>0.05）。Pearson相关分析结果显示，ACS患者LV-GLS与血浆miR-30a水平呈正相关（r=0.418，P=0.000）。多因素logistic回归分析结果显示，较高水平的LV-GLS（OR=1.415）和血浆miR-30a（OR=2.201）是促进ACS近期预后不良的危险因素（P<0.05）。ROC曲线分析结果显示，LV-GLS、血浆miR-30a均具有评估ACS患者近期预后的应用价值（AUC=0.921，AUC=0.825；P<0.05），且联合两个指标可提高评估效能（AUC=0.949，P<0.05）。结论 STE联合血浆miR-30a检测用于评估ACS患者的近期预后，能为临床治疗提供参考，值得推广应用。 |
| 关键词: 斑点追踪超声心动图 miR-30a 急性冠状动脉综合征 预后评估 |
| DOI：10.3969/j.issn.1674-3806.2022.01.09 |
| 分类号:R 541.4 |
| 基金项目:佛山市医学科技攻关项目（编号：2020001004341）；佛山市杰出青年医学人才计划项目 |
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| Clinical study of speckle-tracking echocardiography combined with plasma miR-30a in evaluating the short-term prognosis of patients with acute coronary syndrome |
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ZHAO Juan, CHAI Ren-jie, SONG Shi-bo, et al.
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Department of Ultrasound, the Sixth Affiliated Hospital of South China University of Technology(Nanhai District People′s Hospital of Foshan City), Guangdong 528200, China
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| Abstract: |
| ［Abstract］ Objective To explore the efficacy of speckle-tracking echocardiography(STE) combined with plasma miR-30a in evaluating the short-term prognosis of patients with acute coronary syndrome(ACS), and to provide a reference for guiding clinical treatment. Methods Two hundred and fifty-two ACS patients who were admitted to the Sixth Affiliated Hospital of South China University of Technology from January 2020 to December 2020 were selected, and all of them underwent complete revascularization of the diseased coronary artery. According to the prognosis 1 month after the onset of the disease, the patients were divided into a good prognosis group(199 cases) and a poor prognosis group(53 cases). STE was used to detect left ventricular global longitudinal strain(LV-GLS) and left ventricular ejection fraction(LVEF). Real-time polymerase chain reaction(PCR) method was used to detect the level of plasma miR-30a. Multivariate logistic regression was used to analyze the impact of LV-GLS and plasma miR-30a indicators on the short-term prognosis of ACS patients, and the receiver operating characteristic(ROC) curve method was used to analyze the efficacy of LV-GLS and plasma miR-30a indicators in evaluating the short-term prognosis of ACS patients. Results The LV-GLS of the good prognosis group was lower than that of the poor prognosis group, and the relative expression of plasma miR-30a in the good prognosis group was lower than that in the poor prognosis group, and the differences were statistically significant(P<0.05). However, there was no significant difference in LVEF indicator between the two groups(P>0.05). The results of Pearson correlation analysis showed that there was a positive correlation between LV-GLS and plasma miR-30a levels in ACS patients(r=0.418, P=0.000). The results of multivariate logistic regression analysis showed that higher levels of LV-GLS(OR=1.415) and plasma miR-30a(OR=2.201) were the risk factors for the short-term poor prognosis of ACS(P<0.05). The results of ROC curve analysis showed that both LV-GLS and plasma miR-30a had the application value of evaluating the short-term prognosis of ACS patients(AUC=0.921, AUC=0.825; P<0.05), and the combination of the two indicators could improve the evaluation efficacy(AUC=0.949, P<0.05). Conclusion STE combined with plasma miR-30a detection can be used to assess the short-term prognosis of patients with ACS. The combined detection can provide a reference for clinical treatment, and is worthy of promotion and application. |
| Key words: Speckle-tracking echocardiography(STE) miR-30a Acute coronary syndrome(ACS) Prognosis assessment |
