| Objective:Acute myocardial infarction(AMI)is a disease with high mortality and disability rates,which seriously threatens human health.Early diagnosis and repair or regeneration of damaged cardiac myocytes in AMI have always been the focus of research.Cardiac troponin(cTn)is currently the "golden standard" for clinical diagnosis of AMI,but it has some shortcomings.In addition,myocardial cells in the ischemic region eventually necrosis due to persistent hypoxia during the occurrence of AMI,and reperfusion after restoring coronary artery blood flow will aggravate myocardial cell injury.Therefore,searching for biomarkers with high sensitivity and specificity and methods for repairing or regenerating damaged cardiomyocytes are important for the diagnosis and treatment of AMI.AMI is a process in which coronary blood flow is interrupted,causing acute and continuous ischemia and hypoxia,and eventually leading to local myocardial cell necrosis.We selected four kinds of miRNAs(miR-146 a,miR-135 a,miR-103 and miR-210)which are regulated by ischemia and hypoxia and participate in the regulation of cardiomyocyte apoptosis and necrosis.By measuring the expression levels of these four miRNAs in the exosomes of patients with AMI,we analyzed their potential value in the treatment of AMI and whether they have certain predictive value for the occurrence of AMI.Method:51 inpatients(34 males and 17 females)diagnosed as AMI in our hospital from August 2018 to December 2018 were enrolled in the AMI group,and 29 healthy persons(15 males and 14 females)in the same period were enrolled in the control group.Total RNA in plasma exosomes of the two groups was extracted by exoRNeasy kit.The expression levels of miR-146 a,miR-135 a,miR-103 and miR-210 in plasma exosomes of AMI group and control group were detected by quantitative real-time polymerase chain reaction(qRT-PCR).Receiver operating characteristic curve(ROC)was established to evaluate the predictive ability of miR-146 a,miR-135 a,miR-103 and miR-210 in plasma exosomes for patients with AMI.Results:1.The expression levels of miR-146 a,miR-135 a,miR-103 and miR-210 in plasma exosomes of AMI group and control group were determined.The results showed that compared with the control group,the expression level of miR-146a(2.24±2.78 vs 1.00±0.99;p<0.05)in plasma exosome of AMI group was increased;the expression level of miR-135a(20.76±22.00 vs 1.10±0.87;p<0.01)was significantly increased;the expression level of miR-103(15.63±20.86 vs 1.02 ± 0.77;p<0.01)was significantly increased;and the expression level of miR-210(30.33± 28.85 vs 1.16±0.91;p<0.01)was significantly increased.2.ROC analysis of miR-146 a,miR-135 a,miR-103 and miR-210 was performed to evaluate the predictive ability of miRNA in exosomes for patients with AMI.The results showed that the AUC of miR-146 a was 0.636(95%CI:0.515-0.756;p<0.05),the optimal critical value was 1.087,and the sensitivity and specificity were 58.8% and 72.4%.The AUC of miR-135 a was 0.967(95%CI:0.934-1.000;p<0.01),the optimal critical value was 1.958,and the sensitivity and specificity were 92.2% and 93.1%.The AUC of miR-103 was 0.904(95%CI:0.840-0.968;p<0.01),the optimal critical value was 1.396,and the sensitivity and specificity were 88.2% and 79.3%.The AUC of miR-210 was 0.984(95%CI:0.965-1.000;p<0.01),the optimal critical value was 1.683,and the sensitivity and specificity were 96.1%and 89.7%.Conclusions:1.The expression levels of miR-146 a,miR-135 a,miR-103 and miR-210 in plasma exosomes of AMI patients were higher than those of controls,which were potential therapeutic targets for AMI.2.MiR-135 a,miR-103 and miR-210 in plasma exosomes can be used as markers in the auxiliary diagnosis of AMI. |
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