血清miRNA-21,miRNA-126表达在诊断PCI术后冠状动脉再狭窄的临床应用价值

Clinical Value of Serum miRNA-21 and miRNA-126 Expression in Diagnosis of the Coronary Artery Restenosis after PCI

目的研究血清miRNA-21,miRNA-126检测在诊断经皮冠状动脉介入术(PCI)术后冠状动脉再狭窄(ISR)的临床应用。方法收集82例在泾阳县医院和陕西中医药大学附属医院接受PCI治疗的急性冠脉综合征(ACS)患者(狭窄组30例,未狭窄组52例)及33例体验健康者(对照组)的血清及临床资料,采用real-time qPCR技术检测血清中miRNA-21和miRNA-126的相对表达量,比较分析其在各组中的变化。应用血管内超声(intravascular ultrasound,IVUS)来评价PCI术后再狭窄的发生。结果血清miRNA-21和miRNA-126在对照组、未狭窄组和狭窄组中的表达量分别为(0.22±0.03,0.43±0.08,0.92±0.17)和(0.87±0.15,0.49±0.10,0.23±0.04)。与对照组比较,血清miRNA-21在狭窄组与未狭窄组的表达量明显增高,而miRNA-126表达水平则显著降低,差异均有统计学意义(P=0.000)。狭窄组与未狭窄组比较miRNA-21表达水平明显增高,而miRNA-126表达水平则显著降低,差异均有统计学意义(P=0.000)。IVUS结果显示,狭窄组的斑块面积(PLA)与未狭窄组比较显著增高,而最小管腔面积(MLA)显著降低,其差异均有统计学意义(P=0.000)。两标志物在狭窄组的表达量具有负相关性(r=-0.919,P<0.01)。狭窄组中miRNA-126和miRNA-21水平分别与PLA和MLA具有相关性(r=-0.945,0.926,P<0.01)和(r=0.933,-0.917,P<0.01)。结论血清miRNA-21和miRNA-126水平检测可用于急性冠脉综合征疾病PCI术后冠状动脉再狭窄的诊断以及预测,可能作为该疾病时的基因检测指标之一。

Objective To study the clinical application of serum miRNA-21 and miRNA-126 in diagnosis of the coronary artery restenosis after percutaneous coronary intervention（PCI）.Methods The serum and clinical data of 82 cases of acute coronary syndrome（ACS）patients treated with PCI from the Hospital of Jingyang Country and the Affiliated Hospital of Shaanxi University of Chinese Traditional Medicine（stenosis group consisted of 30 cases,non-stenosis group consisted of 52 cases）,and healthy persons（control group consisted of 33 cases）were collected.The relative expression levels of serum miRNA-21 and miRNA-126 were detected using real-time qPCR technology in the comparative analysis for their changes in the groups.Intravascular ultrasound（IVUS）was used to evaluate the occurrence of restenosis after PCI.Results Serum miRNA-21 and miRNA-126 levels in the control group,the non-stenosis group and the stenosis group were,,（0.22±0.03,0.43±0.08,0.92±0.17）and（0.87±0.15,0.49±0.10,0.23±0.04）,respectively.Compared with the control group,the expression level of serum miRNA-21 in the stenosis group and the non stenosis group were significantly increased,while the miRNA-126 levels was significantly decreased（P=0.000）,the differences were statistically significant.Compared with the non stenosis group,the level of miRNA-21 in the stenosis group was significantly increased,while the level of miRNA-126 was significantly decreased（P=0.000）,the differences were statistically significant.The results of IVUS showed that the plaque area（PLA）of the patients in the stenosis group was significantly higher than that in the non stenosis group,while the minimal luman area（MLA）was significantly decreased,and the differences were statistically significant（P=0.000）.There was a negative correlation between the expression of two markers in the stenosis group（r=-0.919,P〈0.01）.The levels of miRNA-126 and miRNA-21 in the stenosis group were correlated with PLA and MLA（r=-0.945,0.926,P〈0.01）and（r=0.933,-0.917,P〈0.01）.Conclusion The detection of serum miRNA-21 and miRNA-126 levels can be used in diagnosis and prediction for the coronary artary restenosis of ACS after PCI,as the gene detection index of the disease.