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. 2018 Jan;20(1):32-36.
doi: 10.7499/j.issn.1008-8830.2018.01.007.

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

[Article in Chinese]
Affiliations

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

[Article in Chinese]
Zhong-Jing Wu et al. Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jan.

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.

目的: 探讨血浆miRNA-497在小儿脓毒症心肌损伤中的表达及其临床意义。

方法: 纳入148例脓毒症患儿,依据其是否发生心肌损伤分为心肌损伤组(58例)和非心肌损伤组(90例),比较两组血浆miRNA-497、心肌肌钙蛋白I (cTnI)、肌酸激酶同工酶(CK-MB)、N末端B型钠尿肽前体(NT-proBNP)、降钙素原(PCT)、C-反应蛋白(CRP)水平及左室射血分数(LVEF)的变化。绘制受试者工作特征曲线(ROC),评价血浆miRNA-497、cTnI、CK-MB对心肌损伤的诊断价值。应用Pearson相关分析法分析miRNA-497与cTnI、CK-MB、NT-proBNP、PCT、CRP及LVEF的相关性。

结果: 心肌损伤组血浆miRNA-497、cTnI、CK-MB、NT-proBNP、PCT及CRP水平均明显高于非心肌损组(P<0.05)。血浆miRNA-497、cTnI、CK-MB及三项联合诊断心肌损伤的曲线下面积(AUC)分别为0.918、0.931、0.775、0.940。miRNA-497的最佳阈值为2.05时,其诊断心肌损伤的敏感度和特异度较好,分别为90.4%和91.2%。相关分析显示,心肌损伤患儿血浆miRNA-497与cTnI的相关性较好(r=0.728,P<0.01)。

结论: 血浆miRNA-497对小儿脓毒症心肌损伤的诊断价值与cTnI相当,有望作为早期诊断心肌损伤的潜在标志物。

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Figures

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miRNA-497、cTnI及CK-MB诊断心肌损伤的ROC曲线
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miRNA-497与cTnI、CK-MB、NT-proBNP、PCT、CRP及LVEF的相关性

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