MiR-146b在急性Stanford A型主动脉夹层患者外周血清和 主动脉组织中的表达及其临床意义

目的：研究miR-146b在急性Stanford A型主动脉夹层(Stanford type A aortic dissection，TAAD)患者外周血清及 主动脉壁组织中的表达，探讨miR-146b在TAAD发病中的意义及机制。方法：将研究对象分为对照组(n=23)和TAAD 组(n=27)，收集所有研究对象的外周血清、术中主动脉壁组织和临床资料。运用实时荧光定量PCR(quantitative realtime PCR，qRT-PCR)检测各组外周血清及主动脉壁组织中miR-146b的表达水平。比较不同主动脉夹层风险级别的miR- 146b水平，对miR-146b水平与TAAD患者主动脉夹层破裂风险进行相关性分析。运用DIANA LAB-TarBase 6.0数据库及 TargetScan靶基因预测软件预测miR-146b相关靶基因。结果：TAAD组外周血清和主动脉壁组织中miR-146b表达水平均 较对照组增高(P<0.001)；中度风险和重度高危的TAAD患者外周血清和主动脉壁组织中miR-146b的表达水平较轻 度风险患者明显增高(P<0.05)；TAAD外周血清和主动脉壁组织中miR-146b差异表达与主动脉夹层高危风险呈正相 关(r=0.862，0.872；P<0.05)。核因子κB1(nuclear factor kappa B1，NF-κB1)、肿瘤坏死因子受体相关因子6(tumor necrosis factor receptor-associated factor 6，TRAF6)、基质金属蛋白酶-16(matrix metalloproteinase 16，MMP16)和肌动蛋白2(actin alpha 2，ACTA2)为miR-146b的靶基因。结论：TAAD患者外周血清和主动脉壁组织中miR-146b表达升高可能与TAAD发 病及病情严重程度相关。

Expression of miR-146b in peripheral blood serum and aortic tissues in patients with acute type Stanford A aortic dissection and its clinical significance

Objective: To explore expression of miR-146b in peripheral blood serum and aortic wall tissues in patients with acute Stanford type A aortic dissection (TAAD), and to discuss the significance and underlying mechanisms. Methods: The subjects were divided into a control group (excluded relative aortic diseases) (n=23) and a TAAD group (n=27). The miR-146b levels of serum and aortic wall tissues were detected by quantitative real-time PCR (qRT-PCR). Serum miR-146b and aortic wall tissues miR-146b were compared among different risk TAAD groups. The correlations between miR-146b and severity of aortic dissection were analyzed. MiR-146b related target genes were predicted by the DIANA LABTarBase 6.0 and TargetScan. Results: The expression levels of miR-146b in the serum and aortic wall tissues in the TAAD group were significantly elevated compared with those in the control group (P<0.001). Compared with the mild risk group, the miR-146b levels of serum and aortic wall tissues were significantly higher in the moderate risk and severe risk groups (P<0.05). The expression of miR-146b was positively correlated with the risk severity of TAAD patients (r=0.862, 0.872; P<0.05). Nuclear factor kappa B1 (NF-κB1), tumor necrosis factor receptor-associated factor 6 (TRAF6), matrix metalloproteinase 16 (MMP16) and actin alpha 2 (ACTA2) were miR-146b related target genes. Conclusion: The upregulation of miR-146b in peripheral blood serum and aortic wall tissues may contribute to the pathogenesis of TAAD and the severity of this disease.