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冠心病患者外周血微小RNA-210和脂蛋白相关磷脂酶A2表达及意义

Expression and clinical significance of microRNA-210 and lipoprotein-associated phospholipase A2 in patients with coronary heart disease

    摘要
  • 摘要:
      目的  探讨冠心病患者外周血微小RNA-210（miR-210）和脂蛋白相关磷脂酶A2（Lp-PLA2）的表达及临床意义。
      方法  选取113例冠心病患者作为研究对象，入院冠状动脉造影均为阳性（血管直径狭窄≥50%）。依据冠心病分型的不同分为急性心肌梗死（AMI）组42例、稳定型心绞痛（SAP）组37例和不稳定型心绞痛（UAP）组34例。另选取同期106例冠状动脉造影阴性（血管直径狭窄 < 50%）的疑似冠心病患者纳入对照组。采用实时定量荧光PCR（qRT-PCR）和酶联免疫吸附试验（ELISA）法检测患者入院24 h内未用药治疗前的外周血miR-210、Lp-PLA2水平以及心功能相关指标每搏输出量（SV）、心脏指数（CI）和左心室射血分数（LVEF）、冠状动脉病变程度（Gensini评分），并进行Pearson相关性分析，应用多元Logistic回归分析探讨冠心病的主要危险因素。
      结果  AMI组、SAP组、UAP组患者外周血miR-210相对表达量、Lp-PLA2水平均高于对照组，心功能指标均低于对照组，差异有统计学意义（P < 0.05）。Pearson相关性分析结果显示，冠心病患者外周血miR-210与Lp-PLA2呈正相关（P < 0.05）；miR-210、Lp-PLA2均与SV、CI、LVEF呈负相关（P < 0.05），且均与Gensini评分呈正相关（P < 0.05）。多元Logistic回归分析结果显示，miR-210和Lp-PLA2为冠心病患者的独立影响因素。
      结论  外周血miR-210、Lp-PLA2与冠心病的发生发展密切相关，可预测冠心病潜在发病风险，对冠心病的早期诊治和预后评估具有积极意义。

     

    Abstract:
      Objective  To investigate the expression and clinical significance of microRNA-210(miR-210) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in peripheral blood of patients with coronary heart disease.
      Methods  A total of 113 patients with coronary heart disease were selected as research objects, and were positive coronary angiography at admission(stenosis of vessel diameter of 50% and above). According to the classification of coronary heart disease, the patients were divided into acute myocardial infarction (AMI) group (42 cases), stable angina pectoris (SAP) group (37 cases) and unstable angina pectoris (UAP) group (34 cases). Another 106 patients with suspected coronary heart disease with negative coronary angiography (vessel diameter stenosis < 50%) during the same period were included in control group. Quantitative Real-time PCR (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) were used to detect the levels of miR-210, Lp-PLA2 and related indicators of cardiac functionStroke output (SV), cardiac index (CI) and left ventricular ejection fraction (LVEF), degree of coronary artery disease (Gensini score) in peripheral blood within 24 h after admission without drug treatment, and were conducted Pearson correlation analysis. Multivariate Logistic regression analysis was used to explore the main risk factors of coronary heart disease.
      Results  The relative expressions of miR-210 and Lp-PLA2 in peripheral blood of the AMI group, SAP group and UAP group were significantly higher than those of the control group, while the cardiac function indexes were significantly lower than those of the control group(P < 0.05). The results of Pearson correlation analysis showed that miR-210 in peripheral blood of patients with coronary heart disease was positively correlated with Lp-PLA2 (P < 0.05), and both of them were negatively correlated with SV, CI and LVEF, and positively correlated with Gensini score of coronary artery disease degree (P < 0.05). Multivariate stepwise Logistic regression analysis showed that miR-210 and Lp-PLA2 were independent risk factors for patients with coronary heart disease.
      Conclusion  MiR-210 and Lp-PLA2 in peripheral blood are closely related to the occurrence and development of coronary heart disease. They can predict the potential risk of coronary heart disease, and have positive significance for the early diagnosis, treatment and prognosis evaluation of coronary heart disease.

     

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