冠心病患者血浆微小核糖核酸表达与血小板活化水平及其相关性

目的 探讨冠心病患者血浆微小核糖核酸(miR)表达与血小板活化水平及两者的相关性.方法 回顾性分析急性冠脉综合征患者30例(ACS组)、稳定性心绞痛患者30例(SAP组)、健康体检者30例(CT组)的临床资料.ACS组及SAP组患者入院第1天即予阿司匹林肠溶片及氯吡格雷片双联抗血小板治疗,连续7 d.比较治疗前后冠心病患者血浆miR-34a、miR-146a、miR-96、血小板活化依赖性颗粒表面膜蛋白(CD62p)、血小板膜糖蛋白Ⅱb/Ⅲa复合物纤维蛋白原受体(PAC-1)水平及血小板聚集率;分析冠心病患者miR表达水平与血小板活化指标之间的相关性.结果 治疗前,ACS组与SAP组miR-34a、miR-146a、miR-96、PAC-1、CD62p水平及血小板聚集率均高于CT组(P<0.05),且ACS组高于SAP组(P<0.05);治疗后,ACS组与SAP组各指标水平均较治疗前有所下降(P<0.05),但ACS组与SAP组仍高于CT组,且ACS组高于SAP组(P<0.05).结论 不同类型冠心病患者血浆miR-34a、miR-146a、miR-96表达及血小板活化水平均存在差异;miR-34a、miR-146a及miR-96水平可能通过参与血小板的产生或激活的过程而影响冠心病的发生发展.

Plasma microRNA expression and platelet activation level and their correlation in patients with coronary heart disease

Objective To investigate the plasma microRNA ( miR) expression,platelet activation level ,and their correlation in patients with coronary heart disease .Methods The clinical data of 30 cases of acute coronary syndrome ( group ACS ) ,30 cases of stable angina pectoris ( group SAP ) and 30 healthy individuals ( group CT ) were retrospectively analyzed .Patients in group ACS and group SAP were treated with dual antiplatelet therapy with Aspirin Enteric-coated Tablets and clopidogrel tablets for 7 days on the first day of admission.The levels of plasma miR-34a,miR-146a,miR-96,platelet activation-dependent granule membrane protein (CD62p),platelet membrane glycoprotein Ⅱb/Ⅲa complex fibrinogen receptor (PAC-1) and the platelet aggregation rate of the patients with coronary heart disease were compared among the three groups before and after treatment .The correlation between miR expression levels and the indices of platelet activation was analyzed .Results Before treatment,the levels of miR-34a,miR-146a,miR-96,PAC-1 and CD62p,and platelet aggregation rate of group ACS and group SAP were higher than those of group CT (P<0.05),and the levels of the indices above of group ACS were higher than those of group SAP (P<0.05).After treatment,the levels of the indices decreased in group ACS and group SAP compared to the levels before treatment(P<0.05),but the levels of group ACS and group SAP were still higher than those of group CT , and the levels of group ACS were higher than those of group SAP (P <0.05).Conclusion There are significant differences in the miR-34a,miR-146a and miR-96 expressions and the platelet activation level among patients with different types of coronary heart disease . The levels of miR-34a,miR-146a and miR-96 might affect the occurrence and progression of coronary heart disease by involving in the process of platelet production/activation .