血浆miR-126水平与冠状动脉慢血流现象的关系

Relationship between plasma miR-126 and coronary slow flow phenomenon

目的本研究旨在探究血浆中miR-126水平与冠状动脉慢血流(CSF)现象的关系。方法连续性选取2016年8月至2018年3月在首都医科大学附属北京安贞医院行冠脉造影的,符合CSF入组标准的患者53例,在同时段内无冠脉器质性狭窄的且冠脉血流速度正常的患者中参照随机数字表选取56例为对照,收集两组患者的临床资料及血标本。使用实时荧光定量PCR(RT-qPCR)法测定血浆中miR-126的表达水平,探究miR-126与CSF的关系及miR-126对CSF的预测作用。结果CSF组患者的平均TIMI帧数[(34±4)帧比(20±3)帧]、左前降支TIMI帧数[(35±5)帧比(21±3)帧)、左回旋支TIMI帧数[(36±5)帧比(20±3)帧]、右冠脉TIMI帧数[(34±5)帧比(20±3)帧]以及miR-126 (0.25±0.09比0.19±0.10)和超敏C反应蛋白[hs-CRP,(3.0±1.2)mg/L比(2.1±0.9)mg/L]的水平均显著高于对照组,差异有统计学意义(P<0.05)。皮尔森相关分析显示miR-126、hs-CRP水平与患者平均TIMI帧数显著相关(r=0.367,P<0.05),且miR-126与hs-CRP的表达水平也相关(r=0.388,P<0.05)。Logistic回归分析显示,miR-126(OR=2.513)和hs-CRP(OR=1.568)是冠脉慢血流现象的独立危险因素,miR-126对CSF预测的ROC曲线下面积为0.661,当cutoff值定为0.225时,约登指数达到最大,此时miR-126预测CSF的灵敏度为0.660,特异度为0.714。结论血浆中miR-126的表达水平与冠脉慢血流现象显著相关,miR-126是冠脉血流缓慢的潜在生物标志物。

Objective To investigate the relationship between miR-126 in plasma and coronary slow flow (CSF) phenomenon.Methods A total of 109 patients without coronary artery disease who underwent coronary angiography at Beijing Anzhen Hospital Affiliated to Capital Medical University from August 2016 to March 2018 were enrolled.The patients were divided into CSF groups (53 cases) and the control group (56 cases) according to CSF existing or not.Clinical data and blood samples of the participants in two groups were collected.Real-time quantitative PCR (RT-qPCR) was used to determine the expression of miR-126 in plasma,and the relationship between miR-126 and CSF and its predictive effect were analyzed.Results Mean TIMI frame counts (34±4 vs 20±3),left anterior descending TIMI frame counts (35±5 vs 21±3),left gyroscopic TIMI frame counts (36±5 vs 20±3),right coronary TIMI frame counts (34±5 vs 20±35) and expression level of hypersensitive C-reactive protein (hs-CRP,(3.0±1.2) mg/L vs (2.1±0.9) mg/L) and plasma miR-126 (0.25±0.09 vs 0.19±0.10) of the CSF group were significantly higher than those of the control group (P<0.05).Correlation analysis showed that miR-126 and hs-CRP levels were significantly correlated with mean TIMI frame count (r=0.367,P<0.05),and miR-126 was also significantly associated with the hs-CRP level (r=0.388,P<0.05).Logistic regression analysis showed that miR-126 (OR=2.513) and hs-CRP (OR=1.568) were independent risk factors for coronary slow flow.The area under the ROC curve of miR-126 predicting for CSF was 0.661.When the cutoff value was set at 0.225,the Youden index reached the maximum with a sensitivity of 0.660 and a specificity of 0.714.Conclusion The expression level of miR-126 in plasma is significantly correlated with CSF,and miR-126 can be used as a predictor of coronary slow flow phenomenon.