先天性心脏病相关性肺动脉高压患者血miR-18a、miR-27b、miR-130a、miR-204水平研究

The changes of plasma miR-18a, miR-27b, miR-130a, miR-204 in patients with pulmonary arterial hypertension due to congenital heart disease

目的 探索先天性心性脏病相关性肺动脉高压（PAH）患者血清中miR-18a、miR-27b、miR-130a和miR-204的表达水平,以及与PAH的相关性.方法 收集昆明医科大学附属延安医院心血管内科2012年4～12月被确诊为先天性心脏病的患者78例,其中肺动脉压正常组37例,合并轻、中度肺动脉高压组25例,重度肺动脉高压组16例;另设正常对照组20例.应用实时荧光定量PCR （Taqman探针法）检测miR-18a、miR-27b、miR-130a、miR-204在血液中的表达水平,分析先天性心脏病相关性肺动脉高压与miR-NA表达水平之间的关系.结果 先天性心脏病相关肺动脉高压患者血miR-18a、miR-27b、miR-130a表达水平显著上调,miR-204表达水平显著下调.随着肺动脉压力的不断增高,血miR-18a、miR-27b、miR-130a表达量明显升高,miR-204表达量显著下调.直线相关分析显示,先天性心脏病继发性肺动脉高压患者血miR-18a、miR-27b、miR-130a表达水平与肺动脉压力存在高度正相关关系（r=0.927,r=0.927,r=0.933,P＜0.01）,miR-204表达水平与肺动脉压力存在高度负相关关系（r=-0.773,P＜0.01）.结论 血miR-18a、miR-27b、miR-130a、miR-204水平可作为判断先天性心脏病合并肺动脉高压较好的临床血清学指标,预判价值较高.

Objective To detect the serum level of miR-18a,miR-27b,miR-130a and miR-204 in patients with pulmonary arterial hypertension due to congenital heart disease,and investigated the correlation of those with pulmonary hypertension.Methods 78 patients with congenital heart disease in the department of cardiology of Yan＇an Affiliated Hospital of Kunming Medical University between April and Dcemeber 2012 and 20 normal control patients were collected.The patients with congenital heart disease were divided into 37 cases of nonpulmonary arterial hypertension group,25 cases of mild to moderate pulmonary arterial hypertension,and 16 cases of severe pulmonary arterial hypertension.The serum level of miR-18a,miR-27b,miR-130a and miR-204 were detected by using real-time fluoresecnt quantitative PCR （Taqman probe）,and the relationship between serum miRNAs and pulmonary arterial pressure were analyzed and investigated the correlation between and PH.Results The expression level of miR-18a,miR-27b and miR-130a in CHD with PAH patients were significantly higher than normal group,the expression level of miR-204 was significantly lower than normal group.The pulmonary arterial pressure was significant positively correlated with miR-18a,miR-27b,miR-130a （r=0.927,r=0.927,r=0.933,P〈0.01）.Conclusion The expression levels of miR-18a,miR-27b and miR-130a and miR-204 can be used as the good clinical serological indexes for diagnosis of patients with pulmonary arterial hypertension due to congenital heart disease.