外周血微 RNA-223、Nod样受体蛋白 3水平与心绞痛病人冠状动脉钙化的关系

目的检测心绞痛病人外周血微 RNA-223(miR-223)、 Nod样受体蛋白 3(NLRP3)水平并探究其与冠状动脉钙化及严重程度的关系。方法回顾性选取 2019年 12月至 2021年 12月在河北中石油中心医院接受治疗 286例心绞痛病人，入院进行 CT心脏冠状动脉成像检查，根据有无冠状动脉钙化将其分为非钙化组(70例)及钙化组( 216例)。再根据病人冠状动脉钙化积分为轻度钙化组、中度钙化组及重度钙化组。以荧光定量 PCR方法检测外周血 miR-223水平。以酶联免疫吸附法检测外周血 NLRP3水平。 Pearson相关性分析外周血 miR-223、NLRP3水平及二者与高敏 C反应蛋白( hs-CRP)水平的相关性。 Spearman相关分析 miR-223、NLRP3与冠脉狭窄程度( Gensini)积分的相关性。多因素 logistic回归分析影响冠状动脉钙化发生的危险因素。结果钙化组 NLRP3、hs-CRP、Gensini积分水平［(74.12±7.36)ng/L、(3.67±1.35)mg/L、(40.95±5.23)分］明显高于非钙化组［(55.12±6.78)ng/L、(3.15±1.12)mg/L、(13.05±2.59)分］(P<0.05)，miR-223水平(0.52±0.11)低于非钙化组( 0.98±0.32)(P<0.05)；轻度、中度、重度钙化组 NLRP3水平［( 65.42±6.45)ng/L、(72.49±7.23)ng/L、(87.79±8.75)ng/L］、 Gensini积分［( 31.33±4.42)分、(41.82±5.63)分、(52.69±5.80)分］依次升高( P<0.05)， miR-223水平［( 0.72±0.15)、(0.51±0.12)、(0.28±0.06)］依次降低( P<0.05)； Pearson相关性分析显示， NLRP3与 hs-CRP水平、 Gensini积分呈正相关( P<0.05)miR-223与 NLRP3、hs-CRP、Gensini积分水平呈负相关；行多因素 logistic回归分析显示， NLRP3、hs-CRP、合并糖尿病、 miR-223影响冠状动脉钙化的独立危险因素(P<0.05)。结论心绞痛病人外周血 NLRP3呈高表达， miR-223呈低表达，与疾病严重程度及炎症反应关系密切，为影响冠状为，动脉钙化发生的危险因素。

Relationship between peripheral blood microRNA-223 and Nod-like receptor protein 3 levels and coronary artery calcification in patients with angina pectoris

Objective To detect the levels of microRNA-223 (miR-223) and Nod-like receptor protein 3 (NLRP3) in peripheralblood of patients with angina pectoris and explore their relationship with coronary artery calcification and severity.Methods A total of 286 patients with angina pectoris who received treatment in Hebei Central Petroleum Center Hospital from December 2019 to December 2021 were retrospectively selected, and they were admitted to the hospital for CT coronary artery imaging examination. According tothe presence or absence of coronary artery calcification, they were assigned into a non-calcified group (70 cases) and a calcificationgroup (216 cases). According to the coronary artery calcification score, patients were assigned into mild calcification group, moderatecalcification group and severe calcification group. The level of miR-223 in peripheral blood was detected by fluorescence quantitativePCR. The level of NLRP3 in peripheral blood was detected by enzyme-linked immunosorbent assay. Pearson correlation was used to analyze the miR-223 and NLRP3 levels in peripheral blood and their correlation with high-sensitivity C-reactive protein (hs-CRP) level. Spearman correlation analysis was used to analyze the correlation between miR-223, NLRP3 and Gensini score. Multivariate Logisticregression analysis was used to analyze the risk factors influencing the occurrence of coronary artery calcification.Results The levels of NLRP3, hs-CRP and Gensini points (74.12±7.36) ng/L, (3.67±1.35) mg/L, (40.95±5.23) points] in the calcification group were significantly higher than those in the non-calcified group (55.12±6.78) ng/L, (3.15±1.12) mg/L, (13.05±2.59) points] (P<0.05), and the level of miR-223 (0.52±0.11) was lower than that in the non-calcified group (0.98±0.32) (P<0.05); the levels of NLRP3 (65.42±6.45) ng/L,(72.49±7.23) ng/L, (87.79±8.75) ng/L] and Gensini points (31.33±4.42) points, (41.82±5.63) points, (52.69±5.80) points] in the mild,moderate, and severe calcification groups increased in sequence (P<0.05), and the level of miR-223 (0.72±0.15), (0.51±0.12), (0.28±0.06)] decreased in sequence (P<0.05); Pearson correlation analysis showed that NLRP3 was positively correlated with hs-CRP level and Gensini points (P<0.05), miR-223 was negatively correlated with NLRP3, hs-CRP level and Gensini points; Multivariate logistic regression analysis showed that NLRP3, hs-CRP, diabetes mellitus and miR-223 were independent risk factors for coronary artery calcification(P<0.05).Conclusion The high expression of NLRP3 and the low expression of miR-223 in the peripheral blood of patients with angina pectoris are closely related to the severity of disease and inflammation response, are risk factors affecting the occurrence of coronary artery calcification.