血浆miRNA-21和miRNA-126与心肌缺血再灌注损伤的相关性研究

Correlation between plasma miRNA-21 and miRNA-126 and myocardial ischemia reperfusion injury

目的观察血浆微小核糖核酸-21(miRNA-21)、微小核糖核酸-126(miRNA-126)在急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术前后表达水平的变化,探讨二者与心肌缺血再灌注损伤的关系。方法选取2017年6月至2018年12月山西白求恩医院住院治疗的STEMI患者100例,根据冠状动脉造影梗死相关血管心肌梗死溶栓治疗试验血流分级情况分为血管自发再通(SR)组(39例)和非SR组(61例),收集患者临床资料,比较两组患者PCI术前、术后心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、高敏C反应蛋白(hs-CRP)、miRNA-21及miRNA-126的表达水平,分析miRNA-21、miRNA-126与cTnI、CK-MB及hs-CRP的相关性。结果两组患者一般临床资料比较,差异均无统计学意义(均P>0.05)。两组患者PCI术前cTnI、CK-MB及hs-CRP表达水平比较,差异均无统计学意义(均P>0.05);非SR组术后cTnI[(58.43±39.11)ng/ml比(39.66±21.19)ng/ml]、CK-MB[(138.94±69.77)ng/ml比(92.78±37.01)ng/ml]、hs-CRP[(21.33±10.74)mg/L比(16.50±7.64)mg/L]表达水平较SR组更高,差异均有统计学意义(均P<0.05)。两组患者PCI术前miRNA-21和miRNA-126的表达水平比较,差异均无统计学意义(均P>0.05);非SR组患者PCI术后miRNA-21[(1.98±0.46)比(1.68±0.22),P<0.001]、miRNA-126[(2.54±0.56)比(1.63±0.22),P<0.001]表达水平较SR组更高,差异均有统计学意义。Pearson相关性分析显示,miRNA-21表达水平与cTnI(r=0.557,P<0.001)、CK-MB(r=0.625,P<0.001)、hs-CRP(r=0.606,P=0.001)呈正相关,miRNA-126表达水平与cTnI(r=0.543,P=0.004)、CK-MB(r=0.669,P<0.001)、hs-CRP(r=0.558,P=0.002)均呈正相关。结论再灌注损伤时miRNA-21和miRNA-126的表达水平上调,二者与心肌损伤程度呈正相关。

Objective To observe the changes of the expression levels of plasma miRNA-21 and miRNA-126 in patients with acute ST-segment elevation myocardial infarction(STEMI)before and after percutaneous coronary intervention(PCI)and to investigate the relationship with myocardial ischemia reperfusion injury.Methods A total of 100 STEMI patients admitted in Shanxi University Hospital from June 2017 to December 2018 were enrolled in the study,according to the infarction related coronary angiography TIMI fl ow grade,the patients were divided into blood vessels spontaneous recanalization(SR)group(39 cases)and non SR group(61 cases).The clinical data were collected,preoperative and postoperative troponin I(cTnI),creatine kinase isoenzyme(CK-MB),highsensitivity C-reactive protein(hs-CRP),miRNA-21 and the expression of miRNA-126 levels were compared between the two groups,The correlation of miRNA-21 and miRNA-126 with cTnI,CKMB and hs-CRP were analyzed.Results There was no statistically significant difference between the two groups in general clinical data(all P>0.05).There was no statistically significant difference in the expression levels of cTnI,CK-MB or hs-CRP between the two groups before PCI(all P>0.05).The expression levels of cTnI[(58.43±39.11)ng/ml vs.(39.66±21.19)ng/ml],CK-MB[(138.94±69.77)ng/ml vs.(92.78±37.01)ng/ml]and hs-CRP[(21.33±10.74)mg/L vs.(16.50±7.64)mg/L]in the non-SR group were higher than those in the SR group,and the diff erence was statistically signifi cant(all P<0.05).There was no statistically significant difference in the expression levels of miRNA-21 and miRNA-126 between the two groups before PCI(all P>0.05).The expression level of miRNA-21 in the non-SR group after PCI[(1.98±0.46)vs.(1.68±0.22),P<0.001]was higher than that in the SR group.The expression level of miRNA-126 in the non-SR group after PCI[(2.54±0.56)vs.(1.63±0.22),P<0.001]was higher than that in the SR group.Pearson correlation analysis showed that the expression level of miRNA-21 was positively correlated with cTnI(r=0.557,P<0.001),CK-MB(r=0.625,P<0.001),hs-CRP(r=0.606,P=0.001),and the expression level of miRNA-126 was positively correlated with cTnI(r=0.543,P=0.004),CK-MB(r=0.669,P<0.001),and hs-CRP(r=0.558,P=0.002).Conclusions The expression levels of miRNA-21 and miRNA-126 were up-regulated during reperfusion injury,which were positively correlated with the degree of myocardial injury.