急性冠脉综合征患者血清microRNA-21的表达及其与斑块稳定性的关系

Serum microRNA-21 level and its relationship with plaque stability in patients with acute coronary syndrome

目的研究microRNA-21(miR-21)在急性冠脉综合征(ACS)患者血清的表达情况,探讨miR-21对ACS的诊断价值,并分析其与斑块稳定性的关系。方法选择2016年1月至2018年1月收治的45例ACS患者为研究对象,另选择45例冠状动脉狭窄程度<30%的患者作为对照组,收集患者的一般资料,采用RT-PCR检测患者血清miR-21的表达水平,并采用光学相干断层扫描(OCT)检测斑块的稳定性指标。通过受试者工作特征(ROC)分析的方法计算曲线下面积(AUC),计算miR-21对斑块稳定的诊断价值,对miR-21与易损斑块的相关性进行分析。结果与对照组比较,ACS患者血清miR-21明显升高(9.87±0.648 vs 2.37±0.795,P<0.01);miR-21诊断ACS的AUC为0.9814;miR-21与易损斑块的数目、脂质核心的最大面积、巨噬细胞的数量呈线性正相关(P<0.01)。结论ACS患者血清miR-21表达显著升高,与斑块的稳定性呈线性正相关,或可作为ACS的诊断性指标及预后评价指标。

Objective To study the serum level of microRNAs-21(miR-21)in the patients with acute coronary syndrome(ACS)to explore the diagnostic value of miR-21 in ACS and the relationship between miR-21 and plaque stability.Methods Forty-five patients with ACS treated from January 2016 to January 2018 were selected as the research object(ACS group),and 45 patients with coronary artery stenosis less than 30%were selected as the control group.After collecting the general data of patients,the serum level of miR-21 was detected by RT-PCR,and the plaque stability was measured by optical coherence tomography(OCT).The area under the curve(AUC)of receiver operating characteristic(ROC)analysis was calculated to determine the value of miR-21 on plaque stability,and the correlation between miR-21 and vulnerable plaque was analyzed.Results The serum miR-21 level in ACS group was significantly higher than that in control group(9.87±0.648 vs 2.37±0.795,P<0.01).AUC value of miR-21 was 0.9814 in diagnosis of ACS;serum miR-21 level was positively correlated with the number of vulnerable plaques,the largest area of lipid core and the number of macrophages(P<0.01).Conclusion Serum miR-21 significantly increases in ACS patients,which has a positive linear correlation with plaque stability and may be used as a diagnotic index and prognostic indicator for ACS.