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目的本研究探讨心肺复苏后大鼠血浆中心肌损伤相关微小核糖核酸(miRNA)的变化及其意义。方法将64只Sprague-Dawley大鼠分为对照组和实验组,每组各32只。采用窒息法建立大鼠心肺复苏模型,两组分别于气管切开后(对照组)或心肺复苏后(实验组)3、6、12、24 h取静脉血,检测各时间点血浆miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-210、miRNA-320及miRNA-499的表达水平,并采用受试者工作特征(ROC)曲线的曲线下面积评价两组大鼠血浆各miRNA对心搏骤停-心肺复苏后心肌损伤的预测价值。结果实验组与对照组间不同时间点miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-210、miRNA-320和miRNA-499相对表达量比较,差异均有统计学意义(F=223.037、635.809、51.557、167.260、93.157、296.361、622.023,P均<0.001);进一步两两比较发现,miRNA-1、miRNA-133a和miRNA-499在各时间点的相对表达量较对照组均明显上升(P均<0.05);而miRNA-21在各时间点相对表达量较对照组均显著下降(P均<0.001);此外,miRNA-126在3、6、12 h的相对表达量较对照组均明显下调(P均<0.001),而在24 h的相对表达量与对照组比较则显著上调(P<0.001)。miRNA-210在6 h、12 h的相对表达量和miRNA-320在3、6、12 h的相对表达量较对照组均呈上调趋势(P均<0.05)。实验组中,miRNA-1,miRNA-133a,miRNA-210在3 h的相对表达量与24 h的相对表达量比较,差异均无统计学意义(P均>0.05),其余各时点比较差异均具有统计学意义(P均<0.05);miRNA-21和miRNA-126在3 h与6 h的相对表达量比较、6 h与12 h的相对表达量比较,差异均无统计学意义(P均>0.05),其余各时间点间的相对表达量比较,差异均有统计学意义(P均<0.05);而miRNA-320和miRNA-499各个时间点的相对表达量比较,差异均有统计学意义(P均<0.05)。ROC曲线分析结果显示miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499的ROC曲线下面积分别为:0.938、0.912、0.859、0.914、0.805和0.969,敏感度分别为:0.750、1.000、0.875、0.750、1.000和0.875,特异度分别为:1.000、0.750、0.750、1.000、0.750和1.000(P均<0.05),提示miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499对心肺复苏后心肌损伤具有预测价值。结论大鼠心肺复苏后血浆中各miRNA的相对表达量在心肌损伤中有不同的变化,其中miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499对心肺复苏后心肌损伤均具有预测价值。
Objective This study was aimed to investigate the changes and significance of miRNAs associated with myocardial injury in rats after cardiopulmonary resuscitation. Methods 64 Sprague-Dawley rats were divided into control group and experimental group, 32 in each group. The rat model of CPR was established by asphyxiation. Venous blood was collected at 3, 6, 12 and 24 hours after tracheotomy (control group) or cardiopulmonary resuscitation (experimental group), respectively. Plasma miRNA-1 , MiRNA-21, miRNA-126, miRNA-133a, miRNA-210, miRNA-320 and miRNA-499 were measured and the area under the curve of receiver operating characteristic (ROC) Effect of miRNA on Cardiac arrest - Predictors of Myocardial Injury after Cardiopulmonary Resuscitation. Results The relative expression levels of miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-210, miRNA-320 and miRNA-499 in experimental group and control group at different time points were significantly different = 223.037,635.809,51.557,167.260,93.157,296.361,622.023, P <0.001); further comparison showed that the relative expression of miRNA-1, miRNA-133a and miRNA-499 at each time point were significantly higher than those in the control group (P <0.05). However, the relative expression of miRNA-21 at each time point was significantly lower than that of the control group (all P <0.001). In addition, the relative expression of miRNA-126 at 3, 6 and 12 h The control group were significantly decreased (P <0.001), while the relative expression at 24 h was significantly increased (P <0.001) compared with the control group. The relative expression of miRNA-210 at 6 h, 12 h and the relative expression of miRNA-320 at 3, 6, and 12 h were all increased compared with the control group (all P <0.05). In the experimental group, the relative expression levels of miRNA-1, miRNA-133a and miRNA-210 at 3 h were not significantly different from those at 24 h (all P> 0.05), and the differences at other time points (P <0.05). The relative expression levels of miRNA-21 and miRNA-126 at 3 h and 6 h were not significantly different between the 6 h and 12 h (P (All P> 0.05). The relative expression levels at other time points were statistically significant (all P <0.05), while the relative expression levels of miRNA-320 and miRNA-499 at different time points were statistically significant Significance (P <0.05). ROC curve analysis showed that the area under the ROC curve of miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-320 and miRNA-499 were 0.938,0.912,0.859,0.914,0.805 and 0.969 respectively. The sensitivity (0.750, 1.000, 0.875, 0.750, 1.000 and 0.875, respectively) with specificity of 1.000, 0.750, 0.750, 1.000, 0.750 and 1.000 respectively (all P <0.05), suggesting that miRNA-1, miRNA- , MiRNA-133a, miRNA-320 and miRNA-499 have predictive value for myocardial injury after cardiopulmonary resuscitation. Conclusions The relative expression of miRNA in plasma after cardiopulmonary resuscitation (CPR) has different changes in myocardial injury. The effects of miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-320 and miRNA-499 on cardiopulmonary resuscitation After myocardial injury are predictive value.