miR-499、miR-146a在急性冠脉综合征患者中的表达水平以及与冠脉病变程度的相关性

The relevance study of miR-499, miR-146a and the extent of coronary artery lesions in patients with acute coronary syndrome

目的探讨急性冠脉综合征(ACS)患者血小板miR-499、miR-146a表达水平变化以及与冠脉病变程度的相关性。方法选取2016年5月~2017年12月于四川省科学城医院心内科进行冠状动脉造影术(CAG)并住院接受治疗的ACS患者139例。另外选择CAG结果正常的42例受试者作为对照组。比较ACS患者与对照组受试者之间以及ACS不同亚组患者之间血小板miR-499、miR-146a相对表达量的差异,并探讨血小板miR-499、miR-146a表达水平与Gensini评分的相关性。结果 ACS患者血小板miR-499、miR-146a相对表达量和Gensini评分明显高于对照组患者(P<0.05),急性心肌梗死(AMI)患者血小板miR-499、miR-146a相对表达量和Gensini评分明显高于不稳定型心绞痛(UA)患者(P<0.05)。三支病变的ACS患者血小板miR-499、miR-146a相对表达量和Gensini评分明显高于单支病变和双支病变患者(P<0.05)。重度冠脉病变的ACS患者血小板miR-499、miR-146a相对表达量和Gensin评分明显高于中度和轻度病变的ACS患者(P<0.05)。经Pearson相关性分析,ACS患者Gensini评分与血小板miR-499、miR-146a表达呈正相关性(r分别为0.785,0.806,P均<0.05)。结论血小板miR-499、miR-146a表达水平与冠状动脉狭窄病变程度密切相关,可作为诊断或预后的潜在靶点。

Objective To discuss the expressions of platelet miR-499,miR-146a in patients with acute coronary syndrome(ACS)and the relationship with the extent of coronary artery lesions.Methods We analyzed 139 ACS patients treated by coronary angiography(CAG)from May 2016 to December 2017.There were 42 volunteers with normal CAG result selected as the control group.The expression levels of platelet miR-499,miR-146a in all volunteers were compared.And the relationship between the levels of platelet miR-499,miR-146a and Gensini scores of ACS patients were analyzed.Results The relative expression of platelet miR-499,miR-146a in ACS patients were higher than those in control group(P<0.05).The relative expression of platelet miR-499,miR-146a and Gensini scores in patients with acute myocardial infarction(AMI)were higher than the patients with unstable angina(P<0.05).The relative expression of platelet miR-499,miR-146a and Gensini scores in patients with three lesions were higher than those in the patients with one lesion or two lesions(P<0.05).According to the results of pearson analysis,Gensini score was positive correlative with platelet miR-499,miR-146a(P<0.05).Conclusion The platelet miR-499,miR-146a could be the potential targets of diagnosis and the individual gene therapy for acute coronary syndromes,as the acute coronary disease severity predictors.