急性冠状动脉综合征患者血浆miR-133a、miR-208b表达水平及其与心肌损伤和冠状动脉病变程度的相关性

目的分析急性冠状动脉综合征(ACS)患者血浆微小RNA(miR)-133a、miR-208b表达水平及其与心肌损伤指标和冠状动脉病变程度的相关性。方法选取2018年5月—2019年5月云南省第三人民医院心内科收治的ACS患者106例作为研究对象,其中不稳定型心绞痛(UAP)51例(UAP组),急性心肌梗死(AMI)55例(AMI组),另选取同期医院体检健康者40例作为对照(CON组)。比较3组心肌损伤相关指标肌钙蛋白Ⅰ(cTnI)、脑钠肽(BNP)、肌酸激酶同功酶(CK-MB)、左心室射血分数(LVEF)],血浆miR-133a、miR-208b表达水平和冠状动脉病变程度Gensini评分,并分析血浆miR-133a、miR-208b表达水平与心肌损伤指标和Gensini评分的相关性。结果与CON组比较,UAP组和AMI组患者血清cTnI、BNP、CK-MB水平和Gensini评分,血浆miR-133a、miR-208b表达水平均明显升高,且AMI组以上指标水平高于UAP组,而LVEF水平低于UAP组(F=14.836、42.693、37.766、17.239、9.233、11.286、7.643,P均=0.000)。ACS患者血浆miR-133a、miR-208b表达水平与cTnI、BNP、CK-MB及冠状动脉病变程度Gensini评分呈正相关(miR-133a:r/P=0.658/0.000、0.531/0.007、0.602/0.017、0.647/0.002;miR-208b:r/P=0.666/0.000、0.551/0.003、0.625/0.009、0.666/0.013),与LVEF呈负相关(r/P=-0.491/0.023、-0.505/0.011)。结论 ACS患者血浆miR-133a、miR-208b表达水平明显升高,且与心肌损伤指标和冠状动脉病变程度呈明显相关性,可作为ACS的辅助评估指标。

Plasma expression levels of miR-133a and miR-208b in patients with acute coronary syndrome and their correlation with the degree of myocardial injury and coronary artery disease

Objective To analyze the expression levels of plasma microRNA(miR)-133a and miR-208b in patients with acute coronary syndrome(ACS)and their correlation with myocardial injury indexes and the severity of coronary artery lesions.Methods From May 2018 to May 2019,106 patients with ACS admitted to the Department of Cardiology,the Third People's Hospital of Yunnan Province were selected as the research objects,including 51 cases of unstable angina(UAP group)and 55 cases of acute myocardial infarction(AMI group).In addition,40 healthy patients who had physical examination at the hospital during the same period were selected as controls(CON group).Compare 3 groups of myocardial injury related indexesTroponin I(cTnI),brain natriuretic peptide(BNP),creatine kinase isoenzyme(CK-MB),left ventricular ejection fraction(LVEF)],plasma miR-133a,miR-208b The expression level and Gensini score of the degree of coronary artery disease were analyzed,and the correlation between the expression levels of plasma miR-133a and miR-208b and myocardial injury indexes and Gensini score was analyzed.Results Compared with the CON group,serum cTnI,BNP,CK-MB levels and Gensini scores,plasma miR-133a and miR-208b expression levels were significantly increased in the UAP and AMI groups,and the levels of the above indicators in the AMI group were higher than those in the UAP group,while the LVEF level significantly decreased,and the AMI group was lower than the UAP group(F=14.836,42.693,37.766,17.239,9.233,11.286,7.643,P=0.000).Plasma miR-133a and miR-208b expression levels in ACS patients are positively correlated with cTnI,BNP,CK-MB and the Gensini score of coronary artery disease(miR-133a:r/P=0.658/0.000,0.531/0.007,0.602/0.017,0.647/0.002;miR-208b:r/P=0.666/0.000,0.551/0.003,0.625/0.009,0.666/0.013),which is negatively correlated with LVEF(r/P=-0.491/0.023,-0.505/0.011).Conclusion Plasma miR-133a and miR-208b expression levels in ACS patients are significantly increased,and are significantly correlated with myocardial injury indicators and the degree of coronary artery disease,which can be used as auxiliary evaluation indicators for ACS.