目的·研究血清中miR-133a对急性心肌梗死（acute myocardial infarction，AMI）的早期诊断价值及30 d内心血管不良事件发生率的评估价值。方法·纳入紧急胸痛发作6 h内就诊的患者90例，最终确诊AMI 63例、不稳定型心绞痛（unsangina pectoris，UAP）13例和其他病因胸痛（对照）14例。电化学荧光法检测所有患者肌钙蛋白（troponin I，cTnI）、肌酸激酶同工酶（creatine kinase MB，CK-MB）和肌红蛋白（myoglobin，Mb）水平。实时荧光定量PCR（quantitative real-time PCR，qPCR）检测患者入院即刻和经皮冠状动脉介入（percutaneous coronary intervention，PCI）术后24 h血清中的miR-133a表达水平。记录行冠状动脉造影检查的患者Gensini评分。随访患者30 d内心血管不良事件的发生情况。采用Spearman相关分析、多因素Logistic回归分析并绘制受试者工作特征曲线（receiver operator characteristic curve，ROC曲线）对相应数据进行分析。结果·miR-133a在AMI组较UAP组和对照组的表达显著升高（均PPCI 0.716～0.917），预测30 d内心血管不良事件发生的AUC为0.700（95% CI 0.535～0.865）。结论·AMI患者的miR-133a水平显著升高，其有望作为AMI早期诊断的生物标志物；血清中miR-133a水平与冠状动脉狭窄程度及预后可能存在一定的相关性。

Objective · To investigate the value of serum miR-133a in early diagnosis and the assessment of 30-day incidence of cardiovascular adverse events in patients with acute myocardial infarction (AMI). Methods · Ninety patients with acute chest pain within 6 h were included, and 63 cases of AMI, 13 cases of unsangina pectoris (UAP) and 14 cases of control (chest pain of other causes) were finally diagnosed. The levels of troponin I (cTnI), creatine kinase MB (CK-MB) and myoglobin (Mb) were measuredelectrochemical fluorescence. Quantitative real-time PCR (qPCR) was used to detect the of miR-133a in the serum of patients immediately after admission and 24 h after percutaneous coronary intervention (PCI). The Gensini score of patients who underwent coronary angiography was recorded. The incidence of cardiovascular adverse events was observed within 30 days. Spearman correlation analysis, multivariate Logistic regression analysis and receiver operator characteristic curve (ROC curve) were used to analyze the corresponding data. Results · The of miR-133a in the AMI group was significantly higher than that in the UAP group and the control group (both PPCI 0.716-0.917), and the AUC of 30 days cardiovascular adverse event was 0.700 (95% CI 0.535-0.865). Conclusion · The of miR-133a in patients with AMI is significantly increased, which is expected to be a biomarker for early diagnosis of AMI. The level of miR-133a in serum may be related to the severity of coronary artery disease and short-term prognosis.