低辐射剂量模式对肥胖冠心病患者行PCI术后血清miR-133a和miR-208a表达和远期预后的影响

目的探究低辐射剂量模式对肥胖冠心病患者行经皮冠状动脉介入干预（PCI）术后血清miR-133a和miR-208a表达和远期预后影响。 方法选取化州市人民医院明确诊断为冠心病并接受PCI手术治疗的肥胖患者82例，随机分为研究组和对照组，每组各41例。所有患者均行PCI手术治疗，研究组采用低辐射剂量模式，对照组采用常规剂量模式。比较两组患者血清中hs-CRP、miR-133a、miR-208a表达水平、治疗前后心功能指标的变化、经PCI手术治疗后的近期康复情况和远期预后情况。 结果与对照组相比，研究组患者血清中hs-CRP、miR-133a、miR-208a表达水平均有显著降低（P<0.05），术后卧床时间和住院时间均显著缩短（P<0.05）；与手术前相比，研究组患者PCI术后3个月的左室射血分数（lLVEF）、左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）等心功能指标均显著改善（P<0.05），术后1年的心绞痛评分显著的改善（P<0.01）。两组手术成功率和1年随访期主要不良血管事件总发生率差异比较无统计学意义（P>0.05）。 结论低辐射剂量模式能够保证肥胖患者PCI手术的临床疗效，减轻放射性损伤，有利于改善冠心病患者的预后情况。

Effect of low radiation dose mode on serum miR-133a and miR-208a expression and long-term prognosis in obese patients with coronary heart disease after PCI

ObjectiveTo explore the effect of low radiation dose mode on serum miR-133a and miR-208a expression and long-term prognosis in obese patients with coronary heart disease after PCI. MethodsEighty-two patients with a clear diagnosis of coronary heart disease and undergoing PCI in Huazhou People's Hospital were randomly divided into a study group and a control group, with 41 patients in each group. All patients were treated with PCI, and the study group was treated with low-dose radiation mode, while the control group was treated with regular dose mode. The expression levels of hs-CRP, miR-133a and miR-208a in the serum of the two groups, the changes of cardiac function indexes before and after treatment, the short-term recovery and long-term prognosis after PCI were compared. ResultsCompared with the control group, the expression levels of hs-CRP, miR-133a, and miR-208a in the serum of the study group were significantly reduced (P<0.05), and the postoperative bedtime and hospital stay were significantly shortened (P<0.05); Compared with before surgery, the patients in the study group had significantly improved LVEF, LVESD, LVEDD and other cardiac function indicators at 3 months after PCI (P<0.05), and the angina score at 1 year after surgery (P<0.01). There was no statistically significant difference in the surgical success rate and the total incidence of major adverse vascular events during the 1-year follow-up period between the two groups (P>0.05). ConclusionsThe low radiation dose mode can ensure the clinical efficacy of PCI surgery for obese patients, reduce radiation damage, and help improve the prognosis of patients with coronary heart disease.