冠心病患者miR-126、sVCAM-1水平变化及临床意义

Changes and clinical significance of miR-126 and sVCAM-1 levels in patients with coronary artery heart disease

目的探讨冠心病(CHD)患者血浆miR-126、可溶性血管细胞黏附分子-1(sVCAM-1)水平变化及临床意义。方法选择2018年2月—2019年12月在广东省普宁市人民医院住院的CHD患者103例,依据诊断标准分为急性冠脉综合征(ACS)组(58例)和稳定型心绞痛(SAP)组(45例),另选取非CHD体检者55例为对照组。所有患者接受冠状动脉造影术,并采用冠状动脉狭窄程度积分(Gensini)法评价冠状动脉狭窄,检测血浆miR-126和sVCAM-1水平,采用Pearson相关系数进行相关性分析。结果ACS组患者sVCAM-1水平、Genisi评分显著高于SAP组和对照组,miR-126均低于SAP组和对照组(均P<0.05),且SAP组miR-126水平低于对照组,Gensini评分高于对照组(均P<0.05);冠状动脉多支病变和中重度病变患者miR-126分别低于单支病变和轻度病变患者(P<0.05),多支病变和中重度病变患者sVCAM-1分别高于单支病变和轻度病变患者(P<0.05);相关性分析显示,CHD患者miR-126与病变冠状动脉支数(r=-0.536,P=0.007)、Gensini评分(r=-0.574,P=0.015)均呈负相关,sVCAM-1与病变冠状动脉支数(r=0.619,P=0.000)、Gensini评分(r=0.644,P=0.000)呈正相关,miR-126与sVCAM-1呈负相关(r=-0.685,P=0.000)。结论CHD患者存在明显的miR-126表达下调和sVCAM-1表达上调,且上述指标与冠状动脉病变程度密切相关,或许可作为CHD诊断和治疗的参考指标。

Objective To investigate the changes and clinical significance of plasma miR-126 and soluble vascular cell adhesion molecule-1(sVCAM-1)levels in patients with coronary artery heart disease(CHD).Methods One hundred and three cases of CHD patients hospitalized in Puning People′s Hospital of Guangdong Province from February 2018 to December 2019 were selected.They were divided into acute coronary syndrome(ACS)of 58 cases and stable angina pectoris(SAP)of 45 cases according to the diagnostic criteria,and 55 non-CHD patients were selected as the control group.All patients underwent coronary angiography and the Gensini′s degree integral method was used to evaluate coronary artery stenosis.The plasma miR-126 and sVCAM-1 levels were measured,and Pearson correlation coefficient was used for correlation analysis.Results The levels of sVCAM-1 and Gensini′s degree integral score in ACS group were significantly higher than those of SAP group and control group,the levels of miR-126 were all lower than those of SAP group and control group(P<0.05).And the level of miR-126 in SAP group was lower than that of control group,the Gensini′s degree integral score was higher than that of control group(P<0.05).The levels of miR-126 in patients with multiple coronary artery lesions and moderate to severe disease were respectively lower than those in patients with single coronary artery lesion and mild disease(P<0.05).The levels of sVCAM-1 in patients with multiple coronary artery lesions and moderate to severe disease were respectively higher than those in patients with single coronary artery lesion and mild disease(P<0.05).Correlation analysis showed that miR-126 was negatively correlated with the number of coronary artery lesions(r=-0.536,P=0.007)and Gensini′s degree integral score(r=-0.574,P=0.015).sVCAM-1 was positively correlated with the number of coronary artery lesions(r=0.619,P=0.000)and Gensini′s degree integral score(r=0.644,P=0.000).miR-126 was negatively correlated with sVCAM-1(r=-0.685,P=0.000).Conclusion There are significant down-regulation of miR-126 expression and up-regulation of sVCAM-1 expression in CHD patients,and the indexes are closely related to the degree of coronary lesions,which may be used as reference indicators for the diagnosis and treatment of CHD.