血浆miRNA-1、miRNA-21对冠心病合并糖尿病患者PCI术后支架内再狭窄的影响

doi:10.12047/j.cjap.5643.2018.070

中国应用生理学杂志 ›› 2018, Vol. 34 ›› Issue (4): 304-308.doi: 10.12047/j.cjap.5643.2018.070

血浆miRNA-1、miRNA-21对冠心病合并糖尿病患者PCI术后支架内再狭窄的影响

关晶晶¹, 张颖², 刘玉洁²

1. 天津医科大学研究生院, 天津 300070;
2. 天津市胸科医院心内四科, 天津 300222

收稿日期:2017-10-19 修回日期:2018-01-12 出版日期:2018-07-28 发布日期:2019-02-21
通讯作者: 刘玉洁 E-mail:YUJIELIU2011@126.com
基金资助:
天津市卫生局科技基金项目（2012KZ056）

Effects of miRNA-1,miRNA-21 in plasma on in-stent restenosis in patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention

GUAN Jing-jing¹, ZHANG Ying², LIU Yu-jie²

1. The Graduate School, Tianjin Medical University, Tianjin 300070;
2. The Forth Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China

Received:2017-10-19 Revised:2018-01-12 Online:2018-07-28 Published:2019-02-21
Supported by:
天津市卫生局科技基金项目（2012KZ056）

摘要/Abstract

摘要： 目的：观察血浆miRNA-1、miRNA-21在冠心病（CHD）与无冠脉病变患者中含量的差异，探讨其在CHD合并糖尿病（DM）患者的经皮冠状动脉介入治疗（PCI）后发生支架内再狭窄（ISR）与非支架内再狭窄（NISR）患者的含量差异及其对ISR的预测价值。方法：入选CHD支架置入术后患者（CHD组，n=187）、无冠脉病变患者（对照组，n=195）。根据指南，将对照组分为正常对照组（n=150）、单纯DM组（n=45）；将CHD组分为单纯CHD组（n=119）、CHD合并DM组（n=68），又将CHD组分为ISR组（n=48）及NISR组（n=139）；再将ISR组分为单纯ISR组（n=26）和ISR合并DM组（n=22）。收集各组患者血浆，提取总miRNA，检测miRNA-1、miRNA-21含量并分析各组的含量差异。结果：与对照组比较，CHD组miRNA-1、miRNA-21含量均升高（P<0.05）；与NISR组比较，ISR组miRNA-1、miRNA-21含量均升高（P<0.05）。与单纯CHD组比较，CHD合并DM组ISR发生率明显升高；而且与单纯ISR组比较，ISR合并DM组miRNA-21含量升高（P<0.05），而单纯ISR组与ISR合并DM组miRNA-1含量无明显差异（P<0.05）。Logistics分析表明，与CHD患者相关危险因素DM、miRNA-1、miRNA-21的OR值分别为2.132，3.066，1.924（P<0.05，P<0.01）；ISR患者相关危险因素DM、miRNA-21的OR值分别为3.091，5.654（P<0.05，P<0.01）；CHD合并DM患者PCI术后发生ISR相关危险因素miRNA-21的OR值为9.148（P<0.01）。ROC曲线评价表明，miRNA-1，miRNA-21与CHD患者发生ISR的AUC分别为0.854，0.857；miRNA 21与CHD合并DM患者发生ISR的AUC为0.783。结论：血浆miRNA-1、miRNA-21对诊断CHD患者支架置入术后ISR发生有重要临床意义，miRNA-21对诊断CHD合并DM患者支架置入术后ISR发生尤其有重要临床意义。

关键词: miRNA-1, miRNA-21, 冠心病, 支架内再狭窄, 糖尿病

Abstract: Objective: To observe the expression differences of the plasma miRNA-1, miRNA-21 between patients with coronary heart disease (CHD) and without coronary artery lesions, between patients with in-stent restenosis (ISR) and none in-stent restenosis (NISR), and to study their predictive value for ISR occurred after percutaneous coronary intervention (PCI) in patients with CHD and diabetes mellitus (DM). Methods: The selected subjects were divided into CHD group in which patients were implemented stenting (n=187), and control group in which patients were without coronary artery lesions (n=195). According to the guidelines, the control group was divided into normal group (n=150), simple-DM group (n=45); the CHD group was divided into simple-CHD group (n=119) and CHD-DM group (n=68), the CHD group was also divided into ISR group (n=48), NISR group (n=139), and the ISR group was divided into simple-ISR group (n=26) and ISR-DM group (n=22) again. Plasma was collected from each group, and total RNA was extracted, the level of blood miRNA-1, miRNA-21 of each group was detected, and their level differences were analyzed. Results: Compared with control group, the level of miRNA-1 and miRNA-21 of CHD group was increased (P<0.05); compared with NISR group, the level of miRNA-1 and miRNA-21 of ISR group was increased (P<0.05). The incidence of ISR of CHD-DM group was obviously higher than that of simple-CHD group, ISR-DM group's level of miRNA-21 was higher than that of simple-ISR group (P<0.05), and there was no difference of miRNA-1 level between ISR and ISR-DM group (P<0.05). In Logistics, for CHD patents, the OR of DM, miRNA-1, miRNA-21 were 2.132, 3.066, 1.924 respectively (P<0.05); for CHD patents with ISR, the OR of DM, miRNA-21 were 2.123, 3.066 respectively (P<0.05); especially for CHD and DM patents with ISR, the OR of miRNA-21 was 9.148 (P<0.05). In ROC curve, for CHD patients with ISR, the AUC of miRNA-1, miRNA-21 were 0.854, 0.857 respectively; for CHD-DM patients with ISR, the AUC of miRNA-21 was 0.783. Conclusion: To predict the occurrence of ISR for CHD patients, the plasma miRNA-1 and miRNA-21 have a relatively high specificity and sensitivity, for CHD patients with DM, miRNA-21 may have a higher clinical value.

Key words: miRNA-1, miRNA-21, coronary heart disease, in-stent restenosis, diabetes mellitus

关晶晶, 张颖, 刘玉洁. 血浆miRNA-1、miRNA-21对冠心病合并糖尿病患者PCI术后支架内再狭窄的影响[J]. 中国应用生理学杂志, 2018, 34(4): 304-308.

GUAN Jing-jing, ZHANG Ying, LIU Yu-jie. Effects of miRNA-1,miRNA-21 in plasma on in-stent restenosis in patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention[J]. CJAP, 2018, 34(4): 304-308.

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血浆miRNA-1、miRNA-21对冠心病合并糖尿病患者PCI术后支架内再狭窄的影响

Effects of miRNA-1,miRNA-21 in plasma on in-stent restenosis in patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention

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