血浆循环微小RNA-126微小RNA-155与老年冠心病患者冠状动脉支架内再狭窄的相关性分析

An Analysis of the Correlation Between Plasma Circulation MiR-126 MiR-155 and In-Stent Restenosis in Elderly Patients with Coronary Heart Disease

目的:检测老年冠心病患者血浆循环微小RNA-126(miR-126)和微小RNA-155(miR-155)的表达情况,并探讨二者表达水平与患者行经皮冠状动脉介入治疗(PCI)术后发生支架内再狭窄(ISR)发生的相关性。方法:选取2017年8月至2019年9月在本院经冠状动脉造影确诊为冠心病并行PCI的老年患者135例作为研究对象,术后1年复查冠状动脉造影,并根据是否发生ISR分为再狭窄组(n=39)和非再狭窄组(96)。采用实时荧光定量PCR(qRT-PCR)法检测各受试者血浆循环miR-126和miR-155表达水平;通过研究对象工作特征曲线(ROC)评估血浆循环miR-126和miR-155表达水平在老年冠心病患者行PCI术后发生ISR的诊断价值;采用Logistic回归分析老年冠心病患者行PCI术后发生ISR的影响因素。结果:再狭窄组血浆循环miR-126、miR-155表达水平均显著低于非再狭窄组(P<0.05)。ROC结果显示:血浆循环miR-126、miR-155诊断老年冠心病患者行PCI术后发生ISR的AUC分别为0.843、0.708,截断值分别为3.158、1.424,此时对应灵敏度分别为74.0%、59.4%,特异度分别为82.1%、76.9%;血浆循环miR-126、miR-155联合检测老年冠心病患者行PCI术后发生ISR的AUC为0.864,此时对应灵敏度和特异度分别为79.2%、84.6%。Logistic分析显示,血浆循环miR-126、miR-155低表达是影响老年冠心病患者行PCI术后发生ISR的独立危险因素。结论:循环miR-126、miR-155在老年冠心病行PCI术后发生ISR患者血浆中表达水平明显降低,两者参与老年冠心病患者行PCI术后ISR的发生及发展,提示血浆循环miR-126、miR-155可能作为老年冠心病患者行PCI术后发生ISR的早期诊断及病情评估的潜在生物学指标。

Objective:To detect the expressions of plasma circulation microRNA-126(miR-126)and microRNA-155(miR-155)in elderly patients with coronary heart disease,and to explore the correlation between their expression levels and the occurrence of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods:From August 2017 to September 2019,135 elderly patients with coronary heart disease confirmed by coronary angiography and percutaneous coronary intervention(PCI)in our hospital were selected as the study objects,coronary angiography was performed 1 year after operation,and the patients were divided into restenosis group(n=39)and non restenosis group(96).The expression levels of miR-126 and miR-155 were detected by real-time fluorescence quantitative PCR(qRT-PCR);the diagnostic value of plasma circulation miR-126 and miR-155 expressions in elderly patients with coronary heart disease who had ISR after PCI was evaluated by receiver operating characteristic curve(ROC);and Logistic regression analysis was used to analyze the influencing factors of ISR in elderly patients with coronary heart disease after PCI.Results:The expression levels of plasma miR-126 and miR-155 in the restenosis group were significantly lower than those in the non-restenosis group(P<0.05).ROC results showed that AUC of plasma miR-126 and miR-155 was 0.843 and 0.708,respectively,and the cutoff value was 3.158 and 1.424,respectively,at this time,the corresponding sensitivity was 74.0%and 59.4%,and the specificity was 82.1%and 76.9%,respectively;the AUC of ISR after PCI in elderly patients with coronary heart disease detected by plasma circulation miR-126 combined with miR-155 was 0.864,and the corresponding sensitivity and specificity were 79.2%and 84.6%,respectively.Logistic analysis showed that low expressions of miR-126 and miR-155 in plasma circulation were independent risk factors for ISR in elderly patients with coronary heart disease after PCI.Conclusion:The expressions of plasma circulation miR-126 and miR-155 significantly decreased among elderly patients with coronary heart disease who had ISR after PCI and they participate in the occurrence and development of ISR in elderly patients with coronary heart disease after PCI,therefore,it is suggested that miR-126 and miR-155 in plasma circulation may be potential biological indicators for diagnosis and disease assessment of elderly patients with coronary heart disease who had ISR after PCI.