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

• 研究论文 • 上一篇    下一篇

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. 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. 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: 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

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