颅内动脉支架成形术后再狭窄患者血清miRNA-210,miRNA-126水平检测的临床应用价值

目的 研究血清miRNA-210,miRNA-126表达在颅内动脉支架成形术后再狭窄中的临床应用价值。方法 收集113例在延安大学咸阳医院接受颅内动脉支架成形术治疗的颅内动脉狭窄患者(再狭窄组23例,无狭窄组90例)及25例体检健康者(对照组)的血清及临床资料,采用实时逆转录-聚合酶链反应(RT-PCR)技术检测血清miRNA-210和miRNA-126 的表达,比较分析其在各组中的变化。应用颈动脉超声检查评价颅内动脉支架成形术后再狭窄的发生。采用受试者工作特征曲线(ROC曲线)评价血清miRNA-210和miRNA-126的临床意义。结果 血清miRNA-210和miRNA-126 在对照组、无狭窄组和再狭窄组中的表达分别为0.25±0.07,0.53±0.16,0.93±0.23和0.97±0.27,0.67±0.19,0.23±0.09。与对照组比较,血清miRNA-210在再狭窄组和无狭窄组的表达明显增高,而miRNA-126表达则显著降低,差异均有统计学意义; 与无狭窄组比较,再狭窄组miRNA-210表达水平明显增高,而miRNA-126表达则显著降低,其差异均有统计学意义(F=125.9,116.7,P=0.000)。颈动脉超声检查显示,颈内动脉内径(PD)和颈内动脉收缩期峰值流速(PSV)分别在对照组、无狭窄组和再狭窄组中的检查结果为5.51±0.72,4.70±0.63,3.07±0.52 mm和71.27±19.26,93.90±27.38,185.72±75.17 cm/s。与对照组比较,再狭窄组和无狭窄组的PSV均显著增高,而PD则显著降低,其差异均有统计学意义。再狭窄组的PD与无狭窄组比较显著减小,而PSV则显著增快,其差异均有统计学意义(F=38.96,99.75,P=0.000)。miRNA-210和miRNA-126在再狭窄组的表达具有负相关性(r=-0.859,P<0.01),且分别与PD和PSV具有相关性(r=0.868,-0.852,P<0.01),(r=-0.897,0.876,P<0.01)。ROC曲线分析显示血清miRNA-210和miRNA-126水平的AUC分别为0.839(95%CI:0.755～0.942,P<0.01)和0.857(95%CI:0.749～0.966,P<0.01)。结论 血清miRNA-210和miRNA-126水平检测可用于颅内动脉支架成形术后再狭窄的诊断以及预测,并可能成为该疾病的基因检测指标。

Clinical Value of Expression of miRNA-210 and miRNA-126 in Serum in Intracranial Artery Restenosis after Stent Angioplasty

Abstract:Objective To study the clinical value of expression of miRNA-210 and miRNA-126 in serum in the diagnosis of intracranial artery restenosis after stent angioplasty.Methods The serumal and clinical data of 113 cases of patients with intracranial artery stenosis(23 cases in the restenosis group,90 cases in the non- stenosis group)and 25 cases of healthy persons(control group)were collected at Xianyang Hospital of Yan'an University.The relative expression of miRNA-210 and miRNA-126 in serumwas detected by qPCR technique,and compared and analyzed in the groups.Carotid artery ultrasonography was used evaluating occurrence of restenosis after intracranial artery stenting.The clinical significance of serum miRNA-210 and miRNA-126 was assessed via the receiver operating characteristic curve(ROC curve).Results The serumal expression of miRNA-210 and miRNA-126 in the control group,the non stenosis group and the restenosis group was0.25±0.07,0.53±0.16,0.93±0.23 and 0.97±0.27,0.67±0.19,0.23±0.09,respectively.Compared with in the control group,the serumal expressionof miRNA-210 in the restenosis group and the non-stenosis group increased significantly,while the miRNA-126 expression level decreased significantly,and the differences were statistically significant.In the restenosis group,miRNA-210 was significantly higher,but miRNA-126 decreased significantly(F=125.9,116.7,P=0.000),and these differences were statistically significant.According to carotid artery ultrasonography,the carotid artery diameter(PD)and its peak systolic velocity(PSV),repectively,in the control group,the stenosisgroup and the restenosisgroup were 5.51±0.72,4.70±0.63,3.07±0.52 mmand 71.27±19.26,93.90±27.38,185.72±75.17 cm/s,indicating that thesefacts of a decreased PD and increase PSV were noticed in the restenosis and thenon-stenosis groups relatively to those in the control group,and that these were observed in the restenosis group compared with those in the non-stenosis group(F=38.96,99.75,P=0.000).In addition,an inverse relationship was described between the expression of miRNA-210 and miRNA-126 in the restenosis group(r=-0.859,P<0.01),and they were also clarified to be correlated with PD and PSV(r=0.868,-0.852,P<0.01 and r=-0.897,0.876,P<0.01),respectively.ROC curve analysis showed that AUC of miRNA-210 was 0.839(95%CI:0.755～0.942,P<0.01),and of miRNA-126 was 0.857(95%CI:0.749～0.966,P<0.01).Conclusion Detection of serumal miRNA-210 and miRNA-126 can be used for the diagnosis and prediagnosis of restenosis after intracranial artery stenting.They may be served as a marker of gene detection in the disease.