冠状动脉粥样硬化性心脏病患者lncRNA PVT1和miR-145-5p水平与冠状动脉病变相关性分析

Correlation analysis of lncRNA PVT1 and miR-145-5p with coronary lesions in patients with coronary atherosclerotic heart disease

目的探讨血清长链非编码RNA(lncRNA)浆细胞瘤多样性异位基因1(PVT1)和微小RNA-145-5p(miR-145-5p)与冠状动脉粥样硬化性心脏病(简称冠心病)患者冠状动脉病变程度的相关性。方法选取郑州人民医院2020-06-01-2021-12-31收治的179例行冠状动脉造影检查患者作为研究对象,依据诊断结果分为观察组(冠心病103例)和对照组(非冠心病76例)。观察组患者根据病变支数分为单支(35例)、双支(29例)和三支(39例)病变组;根据Gensini评分分为轻度(37例)、中度(26例)及重度(40例)病变组。检测各组血清lncRNA PVT1和miR-145-5p水平并分析相关性;Spearman分析血清lncRNA PVT1、miR-145-5p与Gensini评分相关性;采用多因素logistic回归分析影响冠心病发生的因素。结果与对照组比较,观察组高血压史(χ^(2)=9.189,P=0.002)、糖尿病史(χ^(2)=7.278,P=0.007)、高血脂史(χ^(2)=7.667,P=0.006)比例均较高,差异有统计学意义;观察组血清lncRNA PVT1水平为1.69±0.48,高于对照组的1.01±0.22,t=11.486,P<0.001;血清miR-145-5p水平为0.45±0.17,低于对照组的1.00±0.19,t=20.348,P<0.001。不同病变支数患者血清lncRNA PVT1水平由高至低依次为三支(1.92±0.49)、双支(1.69±0.43)和单支(1.44±0.39)病变组,血清miR-145-5p水平由高至低依次为单支(0.60±0.16)、双支(0.45±0.12)和三支(0.31±0.08)病变组;不同Gensini评分患者血清lncRNA PVT1水平由高至低依次为重度(1.91±0.48)、中度(1.68±0.41)和轻度(1.45±0.42)病变组,血清miR-145-5p水平由高至低依次为轻度(0.61±0.14)、中度(0.43±0.13)、重度(0.32±0.09)病变组,lncRNA PVT1和miR-145-5p水平组间差异均有统计学意义,均P<0.05。观察组血清lncRNA PVT1与miR-145-5p水平呈负相关(r=-0.501,P<0.001),Gensini评分与血清lncRNA PVT1呈正相关(r=0.573,P<0.001),与血清miR-145-5p呈负相关(r=-0.479,P<0.001)。多因素分析结果显示,高血脂史(OR=1.984,95%CI为1.201~3.277,P=0.007)和lncRNA PVT1(OR=2.063,95%CI为1.266~3.361,P=0.004)是影响冠心病发生的独立危险因素,miR-145-5p(OR=0.791,95%CI为0.655~0.955,P=0.015)是保护因素。结论冠心病患者血清lncRNA PVT1水平高表达,血清miR-145-5p水平低表达,均与冠状动脉病变支数、Gensini评分有关,影响疾病进展。

Objective To investigate the relationship between serum long non-coding RNA(lncRNA)plasmacytoma diversity variotype 1(PVT1)and microRNA-145-5p(miR-145-5p)and the degree of coronary artery lesions in coronary atherosclerotic heart disease(CHD for short)patients.Methods A total of 179 patients with coronary angiography were selected from Zhengzhou People’s Hospital from June 1,2020 to December 31,2021.According to the results,they were divided into an observation group(103 cases of coronary heart disease)and a control group(76 cases of non-coronary heart disease).The patients in the observation group were divided into single-vessel(35 cases),double-vessel(29 cases)and three-vessel(39 cases)disease groups according to the number of lesions,mild(37 cases),moderate(26 cases)and severe according to the Gensini score(40 cases)lesion group.The levels of serum lncRNA PVT1 and miR-145-5p in each group were detected and their correlation was analyzed.Spearman analyzed the correlation between serumlncRNA PVT1,miR-145-5pand Gensini score.Multivariate logistic regression was used to analyze the factors affecting the occurrence of coronary heart disease.Results The proportion of history of hypertension(χ^(2)=9.189,P=0.002),diabetes(χ^(2)=7.278,P=0.007)and hyperlipidemia(χ^(2)=7.667,P=0.006)in the observation group were higher than that of the control group,the difference was statistically significant.The level of serumlncRNA PVT1in the observation group was1.69±0.48,higher than that in the control group(1.01±0.22),t=11.486,P<0.001.The serummiR-145-5plevel in the observation group was 0.45±0.17,lower than the control group(1.00±0.19),t=20.348,P<0.001.The serum lncRNA PVT1levels in patients with different number of lesions were three-vessel(1.92±0.49),double-vessel(1.69±0.43),and single-vessel(1.44±0.39)lesion group from high to low,serum miR-145-5plevels from high to low were single-vessel(0.60±0.16),double-vessel(0.45±0.12),and three-vessel(0.31±0.08)lesion groups.SerumlncRNA PVT1levels in patients with different Gensini scores from high to low were in the order of severe(1.91±0.48),moderate(1.68±0.41),and mild(1.45±0.42)lesion groups,serummiR-145-5plevels from high to low were mild(0.61±0.14),moderate(0.43±0.13),and severe(0.32±0.09)lesion groups(all P<0.05).SerumlncRNA PVT1in observation group was negatively correlated with miR-145-5plevel(r=-0.501,P<0.001),Gensini score was positively correlated with serumlncRNA PVT1(r=0.573,P<0.001),and serum miR-145-5p was negatively correlated(r=-0.479,P<0.001).Multivariate analysis showed that history of hyperlipidemia(OR=1.984,95%CI:1.201-3.277,P=0.007),lncRNA PVT1(OR=2.063,95%CI:1.266-3.361,P=0.004)were independent risk factors affecting the occurrence of coronary heart disease,and miR-145-5p(OR=0.791,95%CI:0.655-0.955,P=0.015)were protective factors.Conclusion The serumlncRNA PVT1level in patients with coronary heart disease is highly expressed,and the serum miR-145-5plevel is lowly expressed,both of which are related to the number of coronary artery lesions and Gensini score,which affect disease progression.