慢性稳定性心绞痛患者循环微RNA-92a表达影响因素及其与血管内皮损伤的关系研究

Influencing Factors of Circulatory Level of MicroRNA-92a in Patients of Stable Angina Pectoris

目的分析慢性稳定性心绞痛(SAP)患者循环微RNA-92a(miR-92a)表达的影响因素,探讨循环miR-92a表达与血管内皮损伤的关系。方法 SAP患者116例,入院后次日晨取外周血测定单个核细胞中miR-92a表达量。采用单因变量多因素方差分析SAP患者循环miR-92a表达的影响因素。依据影响因素分组比较SAP患者循环miR-92a表达的差异。结果多因素分析显示,糖尿病(F=5.505,P=0.021)、多支血管病变(F=3.832,P=0.053)对SAP患者循环miR-92a表达的影响有统计学意义(P<0.05)。依据是否合并糖尿病、多支病变将SAP患者分为4组,各组患者循环miR-92a表达均值间差异有统计学意义(P<0.05),由高到低依次为:多支病变合并糖尿病组〔A组,均值0.856,95%CI(0.325,1.387)〕,单支病变合并糖尿病组〔B组,均值0.328,95%CI(-0.033,0.696)〕,多支病变无糖尿病组〔C组,均值-0.033,95%CI(-0.345,0.279)〕,单支病变无糖尿病组〔D组,均值-0.526,95%CI(-0.791,-0.261)〕。4组循环miR-92a表达量两两比较,除A组与B组,B组与C组比较差异无统计学意义(P>0.05)外,其余各组间差异均有统计学意义(P<0.05)。结论 SAP合并糖尿病、冠状动脉多支病变患者循环miR-92a表达上调,表明血管内皮损伤增大循环miR-92a表达。应进一步研究miR-92a调控血管内皮细胞损伤相关基因,针对miR-92a施行干预治疗。

Objective To investigate the influencing factors of circulatory level of microRNA 92a（miR-92a） in patients with stable angina pectoris（SAP） and the relationship between miR-92a and vascular endothelial dysfunction.Methods A total of 116 SAP patients were enrolled in this study.Their peripheral blood mononuclear cells were obtained the next morning after admission to determine miR-92a.Multivariate regression analyses were performed to determine the influencing factors of circulatory level of miR-92a.The differences in the expression of circulating miR-92a were analyzed according to different influencing factors.Results Multivariate analysis showed that the impacts of diabetes and multiple coronary vessel disease on the circulating miR-92a expression were statistically significant（F=5.505,P=0.021;F=3.832,P=0.053,respectively）.According to complicated with or without diabetes and multiple vessel disease,116 patients were divided into four groups：multiple vessel disease with diabetes（Group A）,single vessel disease with diabetes（Group B）,multiple vessel disease without diabetes（Group C）,and single vessel disease without diabetes（Group D）.Group A had the highest miR-92a expression（mean 0.856,95%CI（-0.325,1.387））,followed by Group B（mean 0.328,95%CI（-0.033,0.696））,Group C（mean 0.033,95%CI（-0.345,0.279））,and Group D（mean 0.526,95%CI（0.791,0.261））.There were significant difference of miR-92a expression between Group A and Group C;Group A and Group D;Group B and Group D;Group C and Group D（P0.05）.Conclusion MiR-92a is up-regulated in patients with SAP complicated with diabetes and those who had multiple coronary vessel disease,prompting that endothelial injury may increase the expression of circulating miR-92a.