microRNA-499在急性心肌梗死患者外周血中含量变化的研究

Changes of microRNA-499 level in peripheral blood of acute myocardial infarction patient

目的:通过观察microRNA-499(miR-499)在急性心肌梗死(acute myocardial infarction,AMI)患者血中含量的变化,探讨miRNA-499在AMI病情监测中的作用。方法:连续收集2013年于本院就诊的急性冠脉综合征(acute coronary syndrome,ACS)患者73例,包括AMI患者53例,不稳定心绞痛(unstable angina,UA)患者20例,同期选择本院健康体检志愿者30例为对照。AMI组于症状发作后12 h内、24 h取血,UA组于入院即刻采血。采用Taq Man real-time PCR方法测定miR-499的含量。通过电化学发光法检测血浆肌钙蛋白Ⅰ(c Tn I)及肌酸激酶同工酶(CK-MB)的水平。将AMI组患者根据是否接受急诊经皮冠状动脉介入(PCI)治疗及不同冠脉病变进行分组,分析对比各组间microRNA-499水平的差异。结果:53例AMI患者外周血miR-499的相对表达水平(4.57±2.3),显著高于UA组(2.75±1.39)和健康对照组(0.5±0.39),差异具有统计学意义(P<0.01)。53例AMI患者血浆miR-499的相对表达水平与血清CK-MB、CTn I含量均呈正相关(r=0.361、0.428,P均<0.01)。32例行冠状动脉造影术的AMI组患者中,miR-499的表达在2支及3支病变中高于单支病变(P<0.01);24例成功接受急诊PCI治疗的AMI患者,其症状发作后的24 h血浆miR-499水平较入院即刻时明显降低(P<0.01)。结论:心脏特异表达的miRNA-499在健康人血浆中含量很低,但在心肌梗死后含量明显升高并于早期即可被检测到,具有用于早期诊断以及评估心肌梗死严重程度的价值,可以作为诊断AMI的一个新的敏感的生物学指标。

Objective：To investigate the level of cardio-specific microRNA-499 levels （miR-499） in acute myocardial infarction （AMI） patients and to explore the effect of plasma miR-499 levels on the diagnosis of AMI. Methods： The subjects enrolled in this study, included 30 healthy subjects and 73 patients with suspected acute coronary syndrome（ACS）,who went on our hospital in 2013 and were divided into the AMI group and the unstable angina（UA） group with 53 and 20 patients, respectively. MiR-499 concentrations were measured with a real-time reverse-transcription PCR （qRT-PCR）. Blood samples of the AMI group were collected 12 h and 24 h after the onset of symptom, and those of the UA group were collected after admission. Serum cardiac troponin l （cTnI ） and creatine kinase-MB （CK-MB） concentrations were measured by the electrochemiluminescence method. The 53 AMI patients were further divided into various subgroups according to coronary arteries involved and primary PCI or not, plasma miR-499 concentrations were measured by TaqMan real-time PCR and analyzed between the two groups. Results： The relative level of miR- 499 was significantly increased in patients with AMI （4.57 ± 2.3） than that of UA subjects （2.75 ± 1.39） amt normal subjects （0.5 ±0.39） （both P 〈 0.01 ）. The serum iniR-499 relative level in the patients with AMI had a positive correlation with serum cTuI or CK- MB （r = 0.361, 0.428, respectively, both P 〈 0.01）. It was significantly higher in 32 AMI patients with double or triple coronary arteries stenosis than those with single stenosis （P 〈 0.01 ）. MiR-499 was significantly decreased in 24 patients after received primary PCI （P 〈 0.01）. Conclusion：The plasma concentration of miRNA-499 with cardiac specific expression is low in healthy person, but significantly increase after myocardial infarction and can be detected in the early stage. This can be used for early diagnosis and AMI severity evaulation. The plasma concentration of miR-499 may be a useful biomarker of AMI in humans.