急性冠状动脉综合征患者早期冠状动脉病变的评估

Assessment of Early Coronary Artery Disease in Patients with Acute Coronary Syndrome

目的探讨血浆miR-30a与冠状动脉血管内超声(IVUS)在急性冠状动脉综合征(ACS)患者早期冠状动脉病变评估中的作用。方法随机入选88例ACS患者,包括稳定性心绞痛组(SA组,42例)和ACS组(46例)。用IVUS检测斑块负荷和重构指数(RI),用Real-time PCR法检测血浆miR-30a的含量。研究ACS组斑块负荷、RI和血浆miR-30a的变化。用Pearson相关性分析斑块负荷、血浆miR-30a和RI的关系。结果与SA组比较,ACS组患者斑块负荷增加[(62.82±4.40)%比(68.32±4.59)%];RI增加(0.90±0.03)比(1.15±0.05);血浆miR-30a升高[(8.10±1.09)2-ΔΔct*104比(11.66±1.19)2-ΔΔct*104](P<0.05)。RI和斑块负荷(r=0.482,P=0.000)、血浆miR-30a水平(r=0.817,P=0.000)呈正相关。结论ACS患者早期已发生冠状动脉正性重构,血浆miR-30a可以作为ACS早期冠状动脉病变的评估指标。

Objective To investigate the role of plasma miR-30a and coronary intravascular ultrasound(IVUS)in the early assessment of coronary artery disease in patients with acute coronary syndrome(ACS).Methods 88 ACS patients were randomly selected,including stable angina group(SA group,42 cases)and ACS group(46 cases).Plaque load and remodeling index(RI)were detected by IVUS,and plasma miR-30a was detected by real-time PCR.The changes of plaque load,RI and plasma miR-30a in ACS group were studied.The relationship between plaque load,plasma miR-30a and RI was analyzed by Pearson correlation.Plaque load and remodeling index(RI)were detected by IVUS,and plasma miR-30a was detected by real-time PCR.The changes of plaque load,RI and plasma miR-30a in ACS group were studied.The relationship between plaque load,plasma miR-30a and RI was analyzed by Pearson correlation.Results Compared with SA group,plaque load in ACS group was increased[(62.82±4.40)%vs(68.32±4.59)%];RI increased from(0.90±0.03)to(1.15±0.05);plasma miR-30a[(8.10±1.09)2-ΔΔct*104 vs(11.66±1.19)2-ΔΔct*104]increased.RI was positively correlated with plaque load(r=0.482,P=0.000)and plasma miR-30a level(r=0.817,P=0.000).Conclusion Patients with ACS have early coronary artery positive remodeling,and plasma miR-30a can be used as an evaluation indicator of early ACS coronary artery disease.