外周血miR-483-3p联合D-二聚体检测对下肢深静脉血栓的诊断价值
|
摘要
目的探讨外周血单核细胞微小RNA-483-3p(miR-483-3p)联合D-二聚体对下肢深静脉血栓(DVT)的诊断价值。方法选择2016年9月至2017年6月安徽医科大学第二附属医院确诊的DVT患者30例为血栓组,选取同期住院非DVT患者30例为对照组。分别通过实时荧光定量聚合酶链反应(qRT-PCR)及Sysmex CS5100全自动凝血分析仪检测两组外周血单个核细胞miR-483-3p表达量及血浆中D-二聚体含量。采用受试者工作特征曲线(ROC)统计分析miR-483-3p和血浆D-二聚体分别对DVT诊断的特异性、敏感性和准确率,以及两者联合对DVT诊断的效能。结果与对照组比较,血栓组患者单个核细胞miR-483-3p表达和血浆D-二聚体值升高,差异有统计学意义(P<0.05)。两者对DVT诊断的敏感度和特异度显示,miR-483-3p联合D-二聚体诊断DVT敏感度为96.63%、特异度为90.00%,AUC为0.9382。结论外周血单个核细胞miR-483-3p联合血浆D-二聚体检测可作为诊断下肢深静脉血栓的参考指标。
Objective To investigate the clinical value of peripheral blood detection of microRNA-483-3 p( miR-483-3 p) in monocytes combined with D-dimer levels in diagnosis of deep venous thrombosis( DVT) of lower limbs. Methods Thirty patients diagnosed with DVT in our hospital between Sep 2016 and Jun 2017 were selected as the thrombosis group,and other thirty inpatients without DVT were simultaneously chosen as the control group. Real-time fluorescent quantitative polymerase chain reaction( qRT-PCR) was conducted to detect the expression levels of miR-483-3 p in peripheral blood monocytes in the two groups,and Sysmex CS5100 automatic coagulation analyzer was used to test the plasma levels of D-dimer in them. Then,the specificity,sensitivity and accuracy of DVT diagnosis by blood levels of miR-483-3 p and D-dimer were analyzed by means of receiver operating characteristic( ROC) curve,respectively,and the diagnostic efficacy of miR-483-3 p and D-dimer on DVT diagnosis was also evaluated. Results Compared with the control group,the expression level of miR-483-3 p in monocytes and plasma D-dimer level in the thrombosis group were much higher,with statistically significant differences between them( P < 0. 05). ROC curve analysis showed that the sensitivity and specificity of miR-483-3 p combined with D-dimer in diagnosis of DVT were 96. 6% and 90. 0%,respectively,and their AUC value was 0. 938. Conclusion Combination of expression level of miR-483-3 p in monocytes with plasma D-dimer level could be used as a reference index in the diagnosis of DVT of lower limbs.
Objective To investigate the clinical value of peripheral blood detection of microRNA-483-3 p( miR-483-3 p) in monocytes combined with D-dimer levels in diagnosis of deep venous thrombosis( DVT) of lower limbs. Methods Thirty patients diagnosed with DVT in our hospital between Sep 2016 and Jun 2017 were selected as the thrombosis group,and other thirty inpatients without DVT were simultaneously chosen as the control group. Real-time fluorescent quantitative polymerase chain reaction( qRT-PCR) was conducted to detect the expression levels of miR-483-3 p in peripheral blood monocytes in the two groups,and Sysmex CS5100 automatic coagulation analyzer was used to test the plasma levels of D-dimer in them. Then,the specificity,sensitivity and accuracy of DVT diagnosis by blood levels of miR-483-3 p and D-dimer were analyzed by means of receiver operating characteristic( ROC) curve,respectively,and the diagnostic efficacy of miR-483-3 p and D-dimer on DVT diagnosis was also evaluated. Results Compared with the control group,the expression level of miR-483-3 p in monocytes and plasma D-dimer level in the thrombosis group were much higher,with statistically significant differences between them( P < 0. 05). ROC curve analysis showed that the sensitivity and specificity of miR-483-3 p combined with D-dimer in diagnosis of DVT were 96. 6% and 90. 0%,respectively,and their AUC value was 0. 938. Conclusion Combination of expression level of miR-483-3 p in monocytes with plasma D-dimer level could be used as a reference index in the diagnosis of DVT of lower limbs.
引文
[1]SAEZ-GIMENEZ B,BERASTEGUI C,LOOR K,et al.Deep vein thrombosis and pulmonary embolism after solid organ transplantation:an unresolved problem[J].Transplant Rev(Orlando),2015,29(2):85-92.
[2]STARIKOVA I,JAMALY S,SORRENTINO A,et al.Differential expression of plasma miRNAs in patients with unprovoked venous thromboembolism and healthy control individuals[J].Thromb Res,2015,136(3):566-572.
[3]QIN J,LIANG H,SHI D,et al.A panel of microRNAs as a new biomarkers for the detection of deep vein thrombosis[J].J Thromb Thrombolysis,2015,39(2):215-21.
[4]李晓娟,周勤,魏楠.血浆D-二聚体与纤维蛋白原检测结合超声检查对盆腔手术后下肢深静脉血栓的早期评价价值[J].安徽医学,2016,37(12):1509-1511.
[5]汪波,徐向东,刘敏,等.D-二聚体在深静脉血栓形成诊断中临界值的确定[J].中华普通外科学文献(电子版),2012,6(2):21-23.
[6]KONG L,HU N,DU X,et al.Upregulation of miR-483-3p contributes to endothelial progenitor cells dysfunction in deep vein thrombosis patients via SRF[J].J Transl Med,2016,14:23.
[7]中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(第三版)[J].中华普通外科杂志,2017,32(9):807-812.
[8]SCHOUTEN HJ,GEERSING GJ,KOEK HL,et al.Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism:systematic review and meta-analysis[J].BMJ,2013,346:f2492.
[9]HEIT J A,SPENCER F A,WHITE R H.The epidemiology of venous thromboembolism[J].J Thromb Thrombolysis,2016,41(1):3-14.
[10]WAKERFIELD T W,MCLAFFERTY R B,LOHR J M,et al.Call to action to prevent venous thromboembolism[J].J Vasc Surg,2009,49(6):1620-1623.
[11]MENG Q,WANG W,YU X,et al.Upregulation of MicroRNA-126 Contributes to endothelial progenitor cell function in deep vein thrombosis via its target PIK3R2[J].J Cell Biochem,2015,116(8):1613-1623.
[12]BONAUER A,CARMONA G,IWASAKI M,et al.MicroRNA-92a controls angiogenesis and functional recovery of ischemic tissues in mice[J].Science,2009,324(5935):1710-1713.
[13]GURHA P.MicroRNAs in cardiovascular disease[J].Curr Opin Cardiol,2016,31(3):249-254.
[14]TERUEL-MONTOYA R,ROSENDAAL F R,MARTINEZ C.MicroRNAs in hemostasis[J].J Thromb Haemost,2015,13(2):170-181.
[15]STAKOS D A,GATSIOU A,STAMATELOPOULOS K,et al.Platelet microRNAs:From platelet biology to possible disease biomarkers and therapeutic targets[J].Platelets,2013,24(8):579-589.
[16]EISENREICH A,LEPPERT U.The impact of microRNAs on the regulation of tissue factor biology[J].Trends Cardiovasc Med,2014,24(3):128-132.
[17]MICHIELS J J,GADISSEUR A,VAN DER PLANKEN M,et al.A critical appraisal of non-invasive diagnosis and exclusion of deep vein thrombosis and pulmonary embolism in outpatients with suspected deep vein thrombosis or pulmonary embolism:how many tests do we need?[J].Int Angiol,2005,24(1):27-39.
[2]STARIKOVA I,JAMALY S,SORRENTINO A,et al.Differential expression of plasma miRNAs in patients with unprovoked venous thromboembolism and healthy control individuals[J].Thromb Res,2015,136(3):566-572.
[3]QIN J,LIANG H,SHI D,et al.A panel of microRNAs as a new biomarkers for the detection of deep vein thrombosis[J].J Thromb Thrombolysis,2015,39(2):215-21.
[4]李晓娟,周勤,魏楠.血浆D-二聚体与纤维蛋白原检测结合超声检查对盆腔手术后下肢深静脉血栓的早期评价价值[J].安徽医学,2016,37(12):1509-1511.
[5]汪波,徐向东,刘敏,等.D-二聚体在深静脉血栓形成诊断中临界值的确定[J].中华普通外科学文献(电子版),2012,6(2):21-23.
[6]KONG L,HU N,DU X,et al.Upregulation of miR-483-3p contributes to endothelial progenitor cells dysfunction in deep vein thrombosis patients via SRF[J].J Transl Med,2016,14:23.
[7]中华医学会外科学分会血管外科学组.深静脉血栓形成的诊断和治疗指南(第三版)[J].中华普通外科杂志,2017,32(9):807-812.
[8]SCHOUTEN HJ,GEERSING GJ,KOEK HL,et al.Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism:systematic review and meta-analysis[J].BMJ,2013,346:f2492.
[9]HEIT J A,SPENCER F A,WHITE R H.The epidemiology of venous thromboembolism[J].J Thromb Thrombolysis,2016,41(1):3-14.
[10]WAKERFIELD T W,MCLAFFERTY R B,LOHR J M,et al.Call to action to prevent venous thromboembolism[J].J Vasc Surg,2009,49(6):1620-1623.
[11]MENG Q,WANG W,YU X,et al.Upregulation of MicroRNA-126 Contributes to endothelial progenitor cell function in deep vein thrombosis via its target PIK3R2[J].J Cell Biochem,2015,116(8):1613-1623.
[12]BONAUER A,CARMONA G,IWASAKI M,et al.MicroRNA-92a controls angiogenesis and functional recovery of ischemic tissues in mice[J].Science,2009,324(5935):1710-1713.
[13]GURHA P.MicroRNAs in cardiovascular disease[J].Curr Opin Cardiol,2016,31(3):249-254.
[14]TERUEL-MONTOYA R,ROSENDAAL F R,MARTINEZ C.MicroRNAs in hemostasis[J].J Thromb Haemost,2015,13(2):170-181.
[15]STAKOS D A,GATSIOU A,STAMATELOPOULOS K,et al.Platelet microRNAs:From platelet biology to possible disease biomarkers and therapeutic targets[J].Platelets,2013,24(8):579-589.
[16]EISENREICH A,LEPPERT U.The impact of microRNAs on the regulation of tissue factor biology[J].Trends Cardiovasc Med,2014,24(3):128-132.
[17]MICHIELS J J,GADISSEUR A,VAN DER PLANKEN M,et al.A critical appraisal of non-invasive diagnosis and exclusion of deep vein thrombosis and pulmonary embolism in outpatients with suspected deep vein thrombosis or pulmonary embolism:how many tests do we need?[J].Int Angiol,2005,24(1):27-39.