冠心病患者血清miR-126、miR-155的异常表达与冠状动脉病变程度的相关性研究

Study on the correlation between the abnormal expression of serum miR-126 and miR-155 in patients with coronary heart disease and the degree of coronary artery disease

目的通过检测冠心病患者及健康对照组的血清miR-126、miR-155的表达量,探寻表达量与动脉粥样硬化病变程度的相关性。方法选择2019年12月—2020年9月在齐齐哈尔市第一医院南院心内科经冠脉造影确诊冠心病患者75例作为研究对象,采用美国心脏病协会根据冠脉血管图像分析所得到的Gensini积分系统,对每支冠状动脉血管病变狭窄程度进行定量评定,计算患者总积分并进行分组。按Gensini评分,1-20分为A组29例、21-50分为B组22例、>50分为C组24例;另选取同期在本院体检健康者22名作为正常对照(D组)。结果与D组相比,血清中的miR-126相对表达量在A组表达差异无统计学意义,在B、C组表达差异有统计学意义(P<0.05);血清miR-155相对表达量在A、B组表达差异无统计学意义(P>0.05),在C组表达差异具有统计学意义(P<0.05)。血清miR-126、miR-155的相对表达量诊断冠心病ROC曲线下面积分别是0.666、0.617;联合血清miR-126、miR-155诊断冠心病的ROC曲线下面积为0.695。在Gensini评分最高的C组血清miR-126、miR-155的相对表达量诊断冠心病ROC曲线下面积分别是0.708、0.663;联合血清miR-126、miR-155诊断冠心病的ROC曲线下面积为0.766。采用Pearson检验进行相关分析,在C组血清miR-126的相对表达水平与低密度脂蛋白(low density lipoprotein,LDL)、肌酸激酶同工酶(creatine kinase soenzymes,CKMB)、Gensini评分呈负相关,与血清miR-155呈正相关;血清miR-155的相对表达水平与CKMB、甘油三脂(Triglyceride,TG)、Gensini评分呈负相关。结论血清miR-126、miR-155在冠心病患者血清中表达均下调,可能成为冠心病辅助诊断的一种新的生物学标志物,尤其是在评分较高的C组,可能成为冠状动脉较为严重的多发性狭窄、供血范围减小的独立预测因素,并且对冠心病的严重程度具有一定的提示作用。

Objective Detecting the expression of serum miR-126 and miR-155 in patients with coronary heart disease and healthy controls,the correlation between the expression and the degree of atherosclerotic lesions was explored.Methods Seventy-five patients with coronary artery disease diagnosed by coronary angiography were selected from the department of cardiology,South Hospital of Qiqihar First Hospital from December 2019 to September 2020,and the Gensini scoring system obtained by the American Heart Association based on the analysis of coronary vascular images was used to quantify the stenosis of each coronary artery disease.Assess,calculate the total points of patients and group them.According to the Gensini score,29 cases of patients scored 1-20 were divided into group A,22 cases score 21-50 were divided into group B,24 cases those scored over 50 were divided into group C;22 cases of healthy people in our hospital were selected as normal control group D.Results Compared with the healthy control group,the relative expression of miR-126 in serum was not statistically different in group A,and the differences in expression in group B and C were statistically significant;there was no significant difference in the relative expressions of miR-155 in serum in group A and B compared with that in health controls(P>0.05),and the expression difference in group C was statistically significant(P<0.05).The the area under the ROC curve of serum miR-126 and miR-155 relative expression in the diagnosis of coronary heart disease were 0.666,0.617,respectively;the area under the ROC curve of the combination of serum miR-126 and miR-155 in the diagnosis of coronary heart disease was 0.695.In group C that with the highest Gensini score,the AUC of serum miR-126 and miR-155 relative expression levels for the diagnosis of coronary heart disease were 0.708 and 0.663 respectively;and the AUC of the combination of serum miR-126 and miR-155 for the diagnosis of coronary heart disease was 0.766.Pearson test was used for correlation analysis,and the relative expression level of serum miR-126 in group C was negatively correlated with low density lipoprotein(LDL),creatine kinase soenzymes(CKMB),and Gensini score;however,positively correlated with serum miR-155;the relative expression level of serum miR-155 was negatively correlated with CKMB,triglyceride(TG),and Gensini score.Conclusions Serum miR-126 and miR-155 are down-regulated in the serum of patients with coronary heart disease,which may become a new biological marker for assisted diagnosis of coronary heart disease,especially in group C with a high score.It might be an independent predictor for multiple stenosis of severe coronary arteries and reduced blood supply range,and has a certain prompting effect on the severity of coronary heart disease.