外周血miR-34a、SIRT1 mRNA表达水平与急性心肌梗死患者PCI术后冠状动脉复流情况的相关性

The correlation of miR-34a and SIRT1 mRNA in peripheral blood with coronary no-reflow after PCI in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后外周血微小RNA-34a(miR-34a)、沉默信息调节因子1信使RNA(SIRT1 mRNA)表达水平与冠状动脉复流情况的相关性。方法选取2018年6月至2020年4月在该院首次因急性ST段抬高型心肌梗死行PCI术的患者106例作为研究对象,根据冠心病冠状动脉造影TIMI分级分为无复流组44例和再灌注组62例;另选取同期体检健康志愿者124例作为对照组,所有受试者均接受血清生化指标检测,采用实时荧光定量PCR(RT-qPCR)法测定血清中miR-34a、SIRT1 mRNA表达水平,分析二者表达水平与PCI术后冠状动脉无复流的相关性。结果与对照组、再灌注组相比,无复流组血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、miR-34a表达水平显著升高(P<0.05),SIRT1 mRNA表达水平显著降低(P<0.05);PCI术后患者血清中miR-34a和SIRT1 mRNA表达水平呈负相关(r=-0.578,P<0.05)。miR-34a表达水平升高、SIRT1 mRNA表达水平降低是PCI术后冠状动脉无复流的危险因素(P<0.05)。结论miR-34a在PCI术后冠状动脉无复流患者血清中表达水平显著升高,SIRT1 mRNA表达水平显著降低;miR-34a、SIRT1 mRNA可能参与了AMI患者PCI术后冠状动脉无复流的发生。

Objective To investigate the levels of microRNA-34a(miR-34a)and silence information regulator 1 messenger RNA(SIRT1 mRNA)in peripheral blood of patients with acute myocardial infarction(AMI)after PCI and their effects on coronary no-reflow after percutaneous coronary intervention therapy(PCI).Methods A total of 106 patients with acute ST-segment elevation myocardial infarction who underwent PCI from June 2018 to April 2020 were selected.And according to the TIMI classification of coronary angiography,44 cases were divided into no reflow group and 62 cases into reperfusion group.Another 124 healthy volunteers were selected as the control group,all subjects were tested for serum biochemical indicators,real-time fluorescence quantitative assay(RT-qPCR)was used to detect the levels of miR-34a and SIRT1 mRNA in serum,and the correlations between their expression levels and no-reflow after PCI were analyzed.Results Compared with the control group and the reperfusion group,the levels of serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and miR-34a in the no-reflow group were increased significantly(P<0.05),while the SIRT1 mRNA level decreased significantly(P<0.05).There was a negative correlation between the levels of serum miR-34a and SIRT1 mRNA in patients after PCI(r=-0.578,P<0.05).The levels of miR-34a and SIRT1 mRNA were risk factors for no-reflow after PCI(P<0.05).Conclusion The levels of miR-34a in the serum of patients after PCI has increased significantly,the levels of SIRT1 mRNA has decreased significantly,which may be involved in the occurrence of no coronary reflux in patients with AMI after PCI.