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[血浆中miRNA-1、miRNA-21对冠心病合并糖尿病患者经皮冠状动脉介入治疗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].

作者信息

Guan Jing-Jing, Zhang Ying, Liu Yu-Jie

机构信息

The Graduate School, Tianjin Medical University, Tianjin 300070.

The Forth Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, China.

出版信息

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2018 Apr 8;34(4):304-308 384. doi: 10.12047/j.cjap.5643.2018.070.

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 (=187), and control group in which patients were without coronary artery lesions (=195). According to the guidelines, the control group was divided into normal group (=150), simple-DM group (=45); the CHD group was divided into simple-CHD group (=119) and CHD-DM group (=68), the CHD group was also divided into ISR group (=48), NISR group (=139), and the ISR group was divided into simple-ISR group (=26) and ISR-DM group (=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 (<0.05); compared with NISR group, the level of miRNA-1 and miRNA-21 of ISR group was increased (<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 (<0.05), and there was no difference of miRNA-1 level between ISR and ISR-DM group (<0.05). In Logistics, for CHD patents, the OR of DM, miRNA-1, miRNA-21 were 2.132, 3.066, 1.924 respectively (<0.05); for CHD patents with ISR, the OR of DM, miRNA-21 were 2.123, 3.066 respectively (<0.05); especially for CHD and DM patents with ISR, the OR of miRNA-21 was 9.148 (<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.

CONCLUSIONS

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.

摘要

目的

观察冠心病(CHD)患者与无冠状动脉病变者、支架内再狭窄(ISR)患者与无支架内再狭窄(NISR)患者血浆miRNA-1、miRNA-21的表达差异,研究其对冠心病合并糖尿病(DM)患者经皮冠状动脉介入治疗(PCI)后发生ISR的预测价值。

方法

将入选对象分为行支架置入的CHD组(=187例)和无冠状动脉病变的对照组(=195例)。根据指南,对照组分为正常组(=150例)、单纯DM组(=45例);CHD组分为单纯CHD组(=119例)和CHD-DM组(=68例),CHD组又分为ISR组(=48例)、NISR组(=139例),ISR组再分为单纯ISR组(=26例)和ISR-DM组(=22例)。采集各组血浆,提取总RNA,检测各组血液miRNA-1、miRNA-21水平,并分析其水平差异。

结果

与对照组相比,CHD组miRNA-1和miRNA-21水平升高(<0.05);与NISR组相比,ISR组miRNA-1和miRNA-21水平升高(<0.05)。CHD-DM组ISR发生率明显高于单纯CHD组,ISR-DM组miRNA-21水平高于单纯ISR组(<0.05),ISR组与ISR-DM组miRNA-1水平无差异(<0.05)。在Logistics分析中,对于CHD患者,DM、miRNA-1、miRNA-21的OR值分别为2.132、3.066、1.924(<0.05);对于发生ISR的CHD患者,DM、miRNA-21的OR值分别为2.123、3.066(<0.05);尤其对于发生ISR的CHD和DM患者,miRNA-21的OR值为9.148(<0.05)。在ROC曲线分析中,对于发生ISR的CHD患者,miRNA-1、miRNA-21的AUC分别为0.854、0.857;对于发生ISR的CHD-DM患者,miRNA-21的AUC为0.783。

结论

血浆miRNA-1和miRNA-21对预测CHD患者ISR的发生具有较高的特异性和敏感性,对于CHD合并DM患者,miRNA-21可能具有更高的临床价值。

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