心肌梗死患者血浆外泌体miR-590、miR-371b表达及预后相关性研究

Study on the Relationship Between the Expression of miR-590,miR-371b and Prognosis in Patients with Myocardial Infarction

目的通过分析心肌梗死患者血浆外泌体miR-590、miR-371b的表达研究二者与心肌梗死患者预后的相关性。方法选取2017年1月至2019年1月我院收治的67例心肌梗死患者为研究对象,选取同期健康体检对象67例为对照组。采用实时荧光定量PCR法(q RT-PCR)检测心肌梗死患者组及对照组的血浆外泌体miR-590、miR-371b的表达;分析心肌梗死患者一般临床资料、血浆外泌体miR-590、miR-371b的表达与预后的相关性;对心肌梗死患者出院后随访12个月,分析血浆外泌体miR-590、miR-371b的表达对心肌梗死患者预后的影响;COX回归分析影响心肌梗死预后不良的危险因素。结果与对照组相比,心肌梗死患者血浆外泌体miR-590表达显著降低,miR-371b表达显著升高(P<0.05);与预后良好组相比,预后不良组年龄≥55岁、吸烟例数、梗死部位为前壁者比例以及梗死面积、外泌体miR-371b表达显著升高(P<0.05);外泌体miR-590表达显著降低(P<0.05) miR-590高表达组预后不良比例(22.6%)低于低表达组(52.8%),miR-371b高表达组预后不良比例(52.9%)高于低表达组(24.2%)(P<0.05);多因素COX回归分析表明,梗死部位、梗死面积与外泌体miR-590低表达、miR-371b高表达是影响心肌梗死预后不良的危险因素(P<0.05)。结论血浆外泌体miR-590、miR-371b可能参与心肌梗死的发生,影响患者预后,有望成为心肌梗死潜在的治疗靶点。

Objective To study the relationship between the expressions of miR-590 and miR-371b in plasma exosomes and the prognosis of patients with myocardial infarction.Methods A total of 67 patients with myocardial infarction admitted to our hospital from January 2017 to January 2019 were selected as the study subjects,and 67 healthy subjects in the same period were selected as the control group. The expression of miR-590 and miR-371b in patients with myocardial infarction and control group were detected by real-time fluorescent quantitative PCR(q RT-PCR);the correlation between general clinical data,the expression levels of miR-590 and miR-371b in the plasma exosomes and prognosis was analyzed;patients with myocardial infarction were followed up within 12 months after discharge,the effects of the expressions of miR-590 and miR-371b on the prognosis of patients with myocardial infarction were analyzed;and COX regression analysis was used to analyze the risk factors for poor prognosis of myocardial infarction.Results Compared with those in the control group,the expression of miR-590 in exosomes of patients with myocardial infarction was significantly lower,and the expression of miR-371b was significantly higher(P<0. 05);compared with those in the good prognosis group,the proportions of patients with age ≥ 55 years old,smoking and anterior infarct,the infarct area,the expression of miR-371b in the poor prognosis group were significantly higher(P<0. 05);the expression of miR-590 in the poor prognosis group were significantly lower(P < 0. 05) the poor prognosis rate of miR-590 high expression group(22. 6%) was lower than that of low expression group(52. 8%),and the poor prognosis rate of miR-371b high expression group(52. 9%) was higher than that of low expression group(24. 2%);in addition,multivariate COX regression analysis showed that the infarct location,infarct area,low expression of miR-590 and high expression of miR-371b in exosomes were the risk factors for poor prognosis of myocardial infarction(P<0. 05).Conclusion MiR-590 and miR-371b may be involved in the occurrence of myocardial infarction and affect the prognosis of patients,they may be potential therapeutic targets for myocardial infarction.