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血清微小RNA-128-3p在下肢动脉硬化闭塞症介入术后支架内再狭窄中的临床意义

Clinical significance of serum microRNA-128-3p in patients with restenosis after interventional treatment of lower extremity arteriosclerosis

    摘要
  • 摘要:
    目的 探讨血清微小RNA-128-3p (miR-128-3p)对下肢动脉硬化闭塞症(LEAOD)介入术后支架内再狭窄(ISR)的预测价值。
    方法 选取406例接受血管介入治疗的LEAOD患者作为研究对象, 随访6个月, 将79例发生ISR的患者纳入再狭窄组, 将327例未发生ISR的患者纳入非再狭窄组。采用实时荧光定量聚合酶链式反应(qRT-PCR)法检测血清miR-128-3p水平, 采用酶联免疫吸附测定法检测血清白细胞介素(IL)-6、IL-8、金属蛋白酶组织抑制因子-1(TIMP-1)水平。
    结果 2组术后血清miR-128-3p水平均低于术前, 且再狭窄组手术前后的血清miR-128-3p水平均高于非再狭窄组, 差异有统计学意义(P < 0.05)。受试者工作特征曲线分析显示, 术前血清miR-128-3p水平预测ISR的曲线下面积为0.712(95%CI为0.644~0.781)。再狭窄组中, 有糖尿病史、有高血压病史、年龄≥50岁患者的血清miR-128-3p水平分别高于无糖尿病史、无高血压病史、年龄 < 50岁患者, 差异有统计学意义(P < 0.05)。年龄≥50岁、Fontaine分期Ⅲ~Ⅳ期、有高血压病史、有糖尿病史和术前血清miR-128-3p表达升高均为血管介入治疗后ISR的独立危险因素(P < 0.05)。Pearson相关性分析结果显示, 术前血清miR-128-3p表达水平与血清IL-6、IL-8水平呈显著正相关(rs=0.646、0.621, P < 0.001), 与TIMP-1水平呈显著负相关(rs=-0.759, P < 0.001)。
    结论 血清miR-128-3p或可成为LEAOD患者血管介入治疗后ISR的特异性生物标志物。

     

    Abstract:
    Objective To investigate the predictive value of serum microRNA-128-3p (miR-128-3p) for in-stent restenosis (ISR) after endovascular intervention in patients with lower extremity atherosclerotic occlusive disease (LEAOD).
    Methods A total of 406 LEAOD patients undergoing endovascular interventional therapy were recruited as study objects.At 6 months of follow-up, patients were divided into restenosis group (n=79) and the non-restenosis group (n=327).The levels of serum miR-128-3p were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR), and the levels of serum interleukin (IL)-6, IL-8 and metalloproteinase tissue inhibitor 1(TIMP-1) were detected by enzyme-linked immunosorbent assay.
    Results The levels of serum miR-128-3p levels after surgery in both groups were lower than before surgery, and the serum miR-128-3p levels before and after surgery in the restenosis group were higher than those in the non-restenosis group, the differences were statistically significant (P < 0.05).Receiver operating characteristic curve analysis showed that area under curve of preoperative serum miR-128-3p level in predicting ISR was 0.712(95%CI, 0.644 to 0.781).The miR-128-3p levels were significantly higher in patients with diabetes, hypertension or age≥50 years in the restenosis group (P < 0.05).Age≥50 years, Fontaine stage of Ⅲ to Ⅳ, history of hypertension and diabetes mellitus, and elevated preoperative serum miR-128-3p expression were all independent risk factors for postoperative restenosis (P < 0.05).Pearson correlation analysis showed that preoperative serum miR-128-3p expression was significantly positively correlated with serum IL-6 or IL-8 levels (rs=0.646, 0.621, P < 0.001), negatively correlated with TIMP-1 levels (rs=-0.759, P < 0.001).
    Conclusion Serum miR-128-3p level may be a specific biomarker of ISR in patients with LEAOD after endovascular intervention.

     

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