【作者】 李俊；

【导师】 张静；

【作者基本信息】 安徽医科大学 ， 内科学（心血管病）， 2023， 硕士

【摘要】 引言:急性ST段抬高型心肌梗死是急性冠脉综合征最严重的类型,也是当今人类的主要死因之一。每年在全世界造成180多万人死亡,是一个全球主要的健康负担。在我们医院常规使用心梗三项(c Tn I、CK-MB和Myo)对STEMI做出早期的判断。c Tn I在起病后3-4小时升高;CK-MB在起病4小时升高;Myo在起病后2小时升高。随着中国胸痛中心的建立,优化院前时间的管理,绝大部分患者就诊时的胸痛时间缩短在4小时以内,传统的心梗三项很难对STEMI做出准确的判断,因此积极探寻敏感度和特异度高的新型心肌损伤标志物成为临床研究的焦点。目的:研究血清mi RNA-203对急性ST段抬高型心肌梗死的预测价值。方法:选取2020年12月至2021年12月在我院确诊的STEMI患者70例,选取同期在我院心内科因其他疾病住院同时具有一过性胸痛症状的患者35例,分别收集两组患者血清并进行mi RNA-203半定量实验。收集所有患者的临床资料,对比两组之间的差异、进行ROC分析和多因素Logistic回归统计分析。结果:STEMI组的mi RNA-203高于对照组,差异有统计学意义(P<0.05);mi RNA-203在预测STEMI的AUC面积为0.912,以最大约登指数计算得出其最大AUC面积相应参数截阀值为0.672(敏感性84.3%,特异性82.9%);Logistic回归分析显示,mi RNA-203和白细胞是STEMI的独立危险因素(P<0.05),其OR(95%CI)分别为3.913(1.574-9.728)和2.13(1.247-3.641)。结论:胸痛患者入院时检测血清中mi RNA-203的表达水平,可能有助于对急性ST段抬高型心肌梗死的诊断。更多还原

【Abstract】 Introduction: Acute ST-segment elevation myocardial infarction is the most serious type of ACS and one of the major causes of death in humans today.It causes more than1.8 million deaths worldwide each year and is a major global health burden.Early diagnosis of STEMI is routinely performed in our hospital using three types of myocardial infarction(c Tn I,CK-MB,and Myo).c Tn I was elevated 3-4 hours after onset;CK-MB increased at 4 hours of onset;Myo was elevated 2 hours after onset.With the establishment of the Chinese chest pain Center and the optimization of pre-hospital time management,the chest pain time of most patients is shortened within 4 hours when they see a doctor.It is difficult to make an accurate judgment on the traditional three myocardial infarction STEMI.Therefore,it has become the focus of clinical research to actively explore new markers of myocardial injury with high sensitivity and specificity.Objective: To investigate the predictive value of serum mi RNA-203 in acute ST-segment elevation myocardial infarction(STEMI).Methods: 70 patients with STEMI diagnosed in the Second People’s Hospital of Hefei from December 2020 to December2021 were selected,and 35 patients with transient chest pain who were hospitalized in the Department of Cardiology of our hospital during the same period due to other diseases were selected.Serum from the two groups were collected and mi RNA-203semi-quantitative assay was performed.Clinical data of all patients were collected,the differences between the two groups were compared,and ROC analysis and multivariate Logistic regression statistical analysis were performed.Results: mi RNA-203 in STEMI group was higher than that in control group,the difference was statistically significant(P<0.05).The AUC area of mi RNA-203 was0.912 in predicted STEMI,and the cut-off threshold of the maximum AUC area was0.672(sensitivity 84.3%,specificity 82.9%)by using the maximum approximate entry index.Logistic regression analysis showed that mi RNA-203 and leukocyte were independent risk factors for STEMI(P<0.05),with an OR(95%CI)of 3.913(1.574-9.728)and 2.13(1.247-3.641),respectively.Conclusions: Detection of serum mi RNA-203 expression level in patients with STEMI upon admission may be helpful for the diagnosis of STEMI.更多还原