微小RNA-181b和单核细胞趋化蛋白1表达水平与冠状动脉斑块易损性的关系

Relationship of expression levels of miR-181b and MCP-1 with vulnerability of coronary artery plaques

目的探讨外周血微小RNA-181b(miR-181b)、单核细胞趋化蛋白1(MCP-1)与冠状动脉斑块易损性的关系。方法选取老年冠心病患者232例,根据冠心病类型分为不稳定性心绞痛(UAP)组96例、稳定性心绞痛(SAP)组88例、急性心肌梗死(AMI)组48例。回顾性分析患者临床资料,检测血清miR-181b、MCP-1水平,使用光学相干断层成像技术测量纤维脂质斑块纤维帽厚度。结果3组LDL-C、Gensini评分比较,有统计学差异(P<0.01)。AMI组miR-181b、纤维帽厚度明显低于UAP组、SAP组,MCP-1水平明显高于UAP组、SAP组(P<0.05)。miR-181b与纤维帽厚度呈正相关(r=0.544,P<0.05),MCP-1水平与纤维帽厚度呈负相关(r=-0.518,P<0.05)。miR-181b、MCP-1、Gensini评分、LDL-C是影响纤维帽厚度的独立影响因素(P<0.05,P<0.01)。结论血清miR-181b、MCP-1水平是冠心病患者罪犯病变的薄纤维帽粥样硬化斑块形成的独立影响因素。

Objective To study the relationship of expression levels of miR-181b and monocyte chemoattractant protein 1(MCP-1)with vulnerability of coronary artery plaques.Methods Two hundred and thirty-two CHD patients admitted to our hospital from January 2018 to June 2020 were divided into unstable angina pectoris(UAP)group(n=96),stable angina pectoris(SAP)group(n=88)and acute myocardial infarction(AMI)group(n=48).Their clinical data were retrospectively analyzed.The expressions of miR-181b and MCP-1 were detected by ELISA.The thickness of fibrous cap was measured by optical coherence tomography.Results Significant difference was detected in LDL-C and Gensini score amng the 3 groups(P<0.01).The expression level of miR-181b was significantly lower and the thickness of fibrous cap was significantly thinner in AMI group than in UAP group and SAP group while the expression level of MCP-1 was significantly higher and the thickness of fibrous cap was significantly thicker in MCP-1 group than in UAP group and SAP group(P<0.05).Pearson correlation analysis showed that the expression level of miR-181b was positively related with the thickness of fibrous cap(r=0.544,P<0.05)while that of MCP-1 was negatively related with the thickness of fibrous cap in CHD patients(r=-0.518,P<0.05).Multivariate linear regression analysis displayed that miR-181b,MCP-1,Gensini score and LDL-C were independent risk factors for the thickness of fibrous cap(P<0.05,P<0.01).Conclusion Expression levels of miR-181b and MCP-1 are the independent risk factor for culprit thin fibrous cap atherosclerotic plaques in CHD patients.