循环微小RNA-92a对经皮冠状动脉介入术致血管内皮损伤的评价作用

Evaluation of circulating microRNA-92a for endothelial damage induced by percuatenous coronary intervention

目的探讨循环微小RNA-92a（miR-92a）对介入治疗致血管内皮损伤的评价作用。方法米用前瞻陛病例对照研究，选择58例sT段抬高型急性心肌梗死（STEAMl）接受经皮冠状动脉介入术（PCI）患者，在介入治疗后次日取血测定循环miR-92a表达（逆转录-聚合酶链反应）。分析球囊扩张压力、球囊扩张时间、冠状动脉（冠脉）病变长度与循环miR-92a表达的关系。结果最大球囊扩张压力为ll-19atm（1atrft101．325kPa）者（43例）循环miR-92a表达[均值-0．36，95％可信区间（95％凹）为（-0．60，-0．12）]显著低于扩张压力≤10atm者[11例，均值1．16，95％CI（0．80，1．52），P〈0．01]，也低于≥20atm者[4例，均值0．26，95％CI（0．26，0．26），P=0．1]。最长球囊扩张时间6—7s者（24例）循环miR-92a表达[均值-0．42，95％CI（-0．83，-0．01）]显著低于扩张时间≤5s者[9例，均值0．63，95％CI（0．49，0．78），P=0．03]和≥8s者[25例，均值0．45，95％CI（0．10，0．80），P〈0．001]。植入支架长度≤30mm者（31例）循环miR-92a表达[均值-0．48，95％CI（-0．80，-0．16）]显著低于〉30mm者[27例，均值0．16，95％（2／（0．01，0．32），P〈0．01]。球囊扩张压力与扩张时间呈显著负相关（r=-0．48，P〈0．001）。结论循环miR-92a表达与介入治疗的球囊扩张压力和扩张时间是否适当相关，其具有评价介入治疗所致血管内皮损伤的作用。

Objective To explore the role of microRNA-92a （miR-92a） in evaluating endothelium damage induced by percutaneous coronary intervention （PCI）. Methods A case control study was prospectively conducted. Fifty-eight patients with ST-segment elevation acute myocardial infarction （STEAMI） received PCI were enrolled. MiR-92a expression in circulation was determined on the next day after PCI （reverse transcription-polymerase chain reaction）. The correlation between miR-92a expression in circulation and PCI influence factors, such as inflation pressure, duration of balloon inflation and length of culprit atheromatous plaque were explored. Results MiR-92a was lower in inflation pressure 11-19 arm （1 atm = 101.325 kPa） group [n =43, mean -0.36, 95% confidence interval （95%CI） -0.60 to -0.123 than inflation pressure 10 atm group （n= 11, mean 1.16, 95%CI0.80 to 1.52, P〈0.01 ） and t〉 20 atm group （n = 4, mean 0.26, 95% CI 0.26 to 0.26, P= 0.1 ） ; and also lower in duration of balloon inflation 6-7 seconds group （n =24, mean -0.42, 95%CI-0.83 to -0.01 ） than in duration of balloon inflation ≤ 5 seconds group （n = 9, mean 0.63, 95% CI 0.49 to 0.78, P= 0.03 ） and≤8 seconds group （ n = 25, mean 0.45, 95% CI 0.10 to 0.80, P〈 0.001 ） ; lower in implanted stent length ≤ 30 mm （ n = 31, mean -0.48, 95 % C1-0.80 to -0.16 ） than those 〉30 mm （n=27, mean 0.16, 95%CI0.01 to 0.32, P〈0.01 ）. A significantly negative correlation was found between inflation pressure and duration of balloon inflation. （r=-0.48, P〈0.001 ）. Conclusions There is a relationship between circulating miR-92a, inflation pressure and duration of balloon inflation. Circulating miR-92a could be used to evaluate the endothelium injury induced by PCI, and be used as a new target of prevention and treatment of endothelial dysfunction following revaseularization.