ACS患者PCI后外周血单个核细胞中miR-326水平变化及意义

目的探究急性冠状动脉综合征（acute coronary syndrome，ACS）患者经皮冠状动脉介入术（percutaneous coronary intervention，PCI）后外周血单个核细胞中微RNA-326（microRNA-326，miR-326）水平变化及意义。 方法前瞻性选取在首都医科大学附属北京潞河医院就诊的ACS患者205例作为研究对象。用密度梯度离心法获取外周血中单个核细胞；用实时荧光定量聚合酶链反应法检测单个核细胞中miR-326水平。用Cox回归分析和限制性立方样条分析miR-326与ACS患者预后的关系。 结果预后不良组和预后良好组miR-326水平随时间进展均呈升高趋势（P＜0.05）。PCI后7 d miR-326诊断ACS患者预后的受试者工作特征曲线（receiver operating characteristic curve，ROC）下面积（area under the curve，AUC）高于PCI前miR-326和PCI后3 d miR-326诊断ACS患者预后的ROC AUC，差异均有统计学意义（P＜0.05）。高miR-326组平均生存时间高于低miR-326组，差异有统计学意义（P＜0.05）。Cox回归分析结果显示miR-362（HR=0.039,95%CI：0.016~0.098，P＜0.05）是ACS患者预后的独立保护因素（P＜0.05）。miR-362与ACS患者预后有关（P＜0.05），且为非线性关系（P＜0.05）。miR-326＜0.24时，与miR-326=0.24比较，预后不良的风险升高；当miR-326＞0.24时，与miR-326=0.24比较，预后不良的风险降低。 结论PCI后7 d miR-326与ACS患者预后有关。PCI后7 d miR-326水平低提示预后不良风险较高。

Changes and significance of miR-326 levels in peripheral blood mononuclear cells in patients with ACS after PCI

ObjectiveTo investigate the changes and significance of microRNA-326(miR-326) in peripheral blood mononuclear cells in patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI).MethodsA total of 205 ACS patients treated in Beijing Luhe hospital affiliated to Capital Medical University were selected prospectively as the study subjects. Density gradient centrifugation was performed to obtain mononuclear cells in peripheral blood; real-time fluorescence quantitative PCR was used to detect the level of miR-326 in mononuclear cells. Cox regression analysis and restrictive cubic spline were used to analyze the relationship between miR-326 and the prognosis of ACS patients.ResultsThe level of miR-326 in the poor prognosis group and the good prognosis group showed an increasing trend with time(P＜0.05). The area under the receiver operating characteristic(ROC) curve(AUC) of the prognosis of ACS patients diagnosed with miR-326 at 7 d after PCI was higher than that before PCI and at 3 d after PCI, andthe differences were statistically significant(P＜0.05). The mean survival time of the high miR-326 group was higher than that of the low miR-326 group, and the difference was statistically significant(P＜0.05). Cox regression analysis showed that miR-362［HR=0.039, 95%CI: 0.016-0.098, P＜0.05］ was an independent protective factor for the prognosis of ACS patients(P＜0.05). miR-362 was related to the prognosis of ACS patients(P＜0.05), and had a nonlinear relationship(P＜0.05). When miR-326<0.24, as compared with miR-326=0.24, the risk of poor prognosis was increased; when miR-326>0.24, as compared with miR-326=0.24, the risk of poor prognosis was decreased. ConclusionmiR-326 at 7 d after PCI is associated with the prognosis of ACS patients. Low miR-326 levels at 7 d after PCI suggest a higher risk of poor prognosis.