冠心病患者血清VCAM-1、miR-145、Gal-3、SFRP5水平变化

Changes of Serum VCAM-1,miR-145,Gal-3,SFRP5 Levels in Patients with Coronary Heart Disease

目的探讨冠心病患者血清血管细胞黏附分子-1(VCAM-1)、miR-145、半乳糖凝集素-3(Gal-3)、分泌型卷曲蛋白5(SFRP5)水平变化及意义。方法选取冠心病患者80例为冠心病组,另收集健康志愿者40名为健康对照组。采集清晨空腹肘静脉血,酶联免疫吸附法测定血清VCAM-1、Gal-3、SFRP5浓度;RT-PCR检测血清miR-145表达水平。根据冠脉造影检查诊断的病变支数分为单支病变、双支病变、多支病变。收集两组受试者人口学特征及冠心病患者实验室指标;进行1 a随访,记录不良预后发生情况(病情加重再入院、死亡)。结果冠心病组患者血清VCAM-1、Gal-3水平明显高于健康对照组,miR-145、SFRP5水平明显低于健康对照组(均P<0.01)。急性心肌梗死组患者血清VCAM-1、Gal-3水平明显高于不稳定型心绞痛组、稳定型心绞痛组患者,血清miR-145、SFRP5水平明显低于不稳定型心绞痛组、稳定型心绞痛组患者(均P<0.05)。多支病变患者血清VCAM-1、Gal-3水平明显高于双支病变和单支病变患者,血清miR-145、SFRP5水平明显低于双支病变和单支病变患者(均P<0.05)。预后不良组患者血清VCAM-1、Gal-3水平明显高于预后良好组患者,miR-145、SFRP5水平明显低于预后良好组患者(均P<0.01)。VCAM-1、miR-145、Gal-3、SFRP5水平是冠心病患者预后的独立影响因素;ROC曲线分析显示,血清VCAM-1、miR-145、Gal-3、SFRP5水平联合检测对冠心病患者预后具有较高的预测价值(AUC=0.928)。结论冠心病患者血清VCAM-1、Gal-3水平高表达,miR-145、SFRP5水平低表达,且与冠心病分类、冠脉病变支数密切相关,联合检测对预后具有较高的预测价值。

Objective To investigate the change and significance of serum levels of vascular cell adhesion molecule-1(VCAM-1),miR-145,galactose agglutinin 3(Gal-3),and secretory curl protein 5(SFRP5)in patients with coronary heart disease.Method 80 patients with coronary heart disease were selected as the coronary heart disease group,and 40 healthy volunteers were collected as the healthy control group.Collect fasting elbow vein blood in the morning,and measure serum VCAM-1,Gal-3 and SFRP5 concentrations using enzyme-linked immunosorbent assay;RT-PCR was used to detect the expression level of miR-145 in serum.According to the number of lesions diagnosed by coronary angiography,they are divided into single vessel lesions,double vessel lesions and multi vessel lesions.Collect demographic characteristics of subjects in two groups and laboratory indicators of patients with coronary heart disease;Follow up for one year and record the occurrence of adverse prognosis(worsening of the condition,re-admission,death).Results The serum levels of VCAM-1 and Gal-3 of patients in coronary heart disease group were significantly higher than those of healthy control group,while levels of miR-145 and SFRP5 were significantly lower than those of healthy control group(all P<0.01).Serum levels of VCAM-1 and Gal-3 of patients in acute myocardial infarction group were significantly higher than those of patients in unstable angina group and stable angina group,while serum levels of miR-145 and SFRP5 were significantly lower than those of patients in unstable angina group and stable angina group(all P<0.05).Serum levels of VCAM-1 and Gal-3 of patients with multiple vessel lesions were significantly higher than those of patients with double vessel disease and single vessel disease,while serum levels of miR-145 and SFRP5 were significantly lower than those of patients with double vessel disease and single vessel disease(all P<0.05).Serum levels of VCAM-1 and Gal-3 of patients with poor prognosis were significantly higher than those of patients with good prognosis,while levels of miR-145 and SFRP5 were significantly lower than those of patients with good prognosis(all P<0.01).Levels of VCAM-1,miR-145,Gal-3 and SFRP5 were independent prognostic factors for patients with coronary heart disease.ROC curve analysis shows that the combined detection of serum levels of VCAM-1,miR-145,Gal-3 and SFRP5 has high predictive value for the prognosis of patients with coronary heart disease(AUC=0.928).Conclusion Patients with coronary heart disease have high expression of VCAM-1 and Gal-3 levels in serum,while low expression of miR-145 and SFRP5 levels,which are closely related to the classification of coronary heart disease and the number of coronary artery lesions,combined detection has high predictive value for prognosis.