外周血sVCAM-1、miR-126水平与冠状动脉狭窄病变程度的关系

The relationships between the levels of sVCAM-1 and miR-126 in peripheral blood and the degree of coronary stenosis

目的探讨外周血血浆血管细胞间粘附分子-1(sVCAM-1)与微小RNA-126(miR-126)表达水平及其与冠状动脉狭窄病变严重程度的关系。方法收集2017年3月-2019年4月因胸口疼痛或胸闷等症状在河南科技大学第三附属医院行冠脉造影的患者175例,根据造影结果分为无病变组87例、单支病变组32例、双支病变组29例和三支病变组27例。采用实时荧光定量PCR(qRT-PCR)检测外周血浆miR-126水平,酶联免疫吸附法检测sVCAM-1水平,采用Gensini评分评价冠状动脉狭窄程度,Pearson法分析各组患者外周血血浆中sVCAM-1、miR-126水平与病变严重程度的相关性;采用受试者工作曲线(ROC)分析外周血血浆中sVCAM-1、miR-126水平对冠状动脉狭窄病变的诊断价值。结果四组患者之间性别、年龄、吸烟比例及高血压比例、糖尿病比例、高脂血症比例、左室射血分数(LVEF)、心脏每搏量(SV)、总胆固醇(TC)、血糖、肌酐(Cr)、尿酸(UA)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)水平比较,差异无统计学意义(P>0.05),四组患者收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异有统计学意义(P<0.05)。与无病变组相比,单支病变组、双支病变组和三支病变组患者Gensini积分、血浆sVCAM-1水平依次升高,血浆miR-126水平依次下降,差异均有统计学意义(P<0.05)。Pearson法分析显示,冠状动脉病变患者血浆中sVCAM-1水平与Gensini积分呈正相关(r=0.529,P<0.05),miR-126水平与Gensini积分呈负相关(r=-0.361,P<0.05)。经ROC曲线分析显示,血浆sVCAM-1、miR-126水平预测冠状动脉狭窄病变的ROC曲线下面积分别为0.846、0.805。结论血浆sVCAM-1、miR-126水平与冠状动脉狭窄病变严重程度密切相关,可能作为冠状动脉狭窄病变的预测指标。

Objective To investigate the expressions of vascular intercellular adhesion molecule-1(sVCAM-1)and microRNA-126(miR-126)in peripheral blood plasma and their relationships with the severity of coronary artery stenosis.Methods From March 2017 to April 2019,175 patients who underwent coronary angiography in our hospital due to chest pain or chest distress were collected and divided into non pathological group(87 cases),single vessel pathological group(32 cases),double vessel pathological group(29 cases)and three vessel pathological group(27 cases).The level of miR-126 was detected by real-time fluorescent quantitative PCR(qRT-PCR);the level of sVCAM-1 was detected by enzyme linked immunosorbent assay;the degree of coronary stenosis was evaluated by Gensini score.Pearson method was used to analyze the correlations between the levels of sVCAM-1,miR-126 and the severity of the disease,and the diagnostic values of sVCAM-1 and miR-126 in peripheral blood plasma for coronary artery stenosis were analyzed by receiver operating characteristic curve(ROC).Results There was no significant differences in gender,age,percentage of smoking,hypertension,diabetes,hyperlipidemia,LVEF,SV,TC,blood glucose,Cr,UA,ALT,AST,and BUN among the four groups(P>0.05).The levels of SBP,DBP,TG,HDL-C and LDL-C in the four groups were compared,and the differences were statistically significant(P<0.05).Compared with the non lesion group,the Gensini scores and the levels of plasma sVCAM-1 in the single vessel pathological group,the double vessel pathological group and the three vessel pathological group increased in turn(P<0.05),and the levels of plasma miR-126 decreased in turn(P<0.05).Pearson analysis showed that sVCAM-1 in plasma was positively correlated with Gensini score(P<0.05),and miR-126 was negatively correlated with Gensini score(P<0.05).ROC curve analysis showed that the areas under ROC curve of coronary artery stenosis predicted by plasma sVCAM-1 and miR-126 were 0.846 and 0.805,respectively.Conclusion The levels of sVCAM-1 and miR-126 in plasma were closely related to the severity of coronary artery stenosis,which might serve as a predictor of coronary artery stenosis and provide some reference for clinical practice.