血浆微小RNA-223及叉头框蛋白3a水平与冠心病患者心脏结构及功能的相关性研究

Correlation between plasma micro-223 and Forkhead Box 3a levels and cardiac structural changes in coronary heart disease patients

目的探讨血浆微小RNA-223(miR-223)及叉头框蛋白3a(FoxO3a)水平与冠心病患者心脏结构变化的相关性。方法纳入2019年1月至2020年12月在新疆医科大学第一附属医院住院的126例冠心病患者为研究组和111例非冠心病患者为对照组,平均年龄(66.38±12.12)岁比(49.35±9.60)岁。通过酶联免疫分析法,检测所有研究对象血浆miR-223及FoxO3a水平,分析其与超声心动图中左心房(LA)、右心房(RA)、左心室舒张末期容积(EDV)、左心室收缩末期容积(ESV)、室间隔、右心室流出道、右心室(RV)、肺动脉、室壁运动评分、MV-E、MV-A、MV-E/A和射血分数(EF)等指标的关系。结果两组在年龄、合并高血压方面差异具有统计学意义(t=6.954、χ^(2)=12.014,P=0.000、0.001)。研究组miR-223[(0.415±0.065)ng/L比(0.309±0.057)ng/L]、FoxO3a[(0.402±0.058)ng/L比(0.306±0.059)ng/L]水平明显高于对照组,且差异具有统计学意义(P<0.05)。相关分析中,miR-223和FoxO3a水平间呈正相关(r=0.485,P=0.000)。miR-223和FoxO3a水平与冠心病之间,年龄成为控制变量后仍呈相关性(r=0.388,P=0.000;r=0.506,P=0.000)。miR-223水平与心脏超声各指标中与LA、EDV、ESV、RA、室壁运动评分呈正相关(r=0.358、0.338、0.339、0.282、0.274,P=0.001、0.002、0.002、0.012、0.015)。FoxO3a水平与超声心动图各指标中与LA、EDV、ESV、室壁运动评分呈正相关(r=0.302、0.312、0.380、0.373,P=0.007、0.005、0.001、0.001),与FE呈负相关(r=-0.278,P=0.013)。结论血浆miR-223、FoxO3a水平在冠心病患者中明显升高,呈高表达状态,并与冠心病患者发生心脏结构的变化有一定的相关性。

Objective To investigate the correlation between plasma miR-223 and Forkhead box 3 a(FoxO3 a)levels and cardiac structural changes in elderly patients with coronary heart disease.Methods From January 2019 to December 2020,126 patients with coronary heart disease and 111 individuals without coronary heart disease in the First Affiliated Hospital of Xinjiang Medical University were enrolled as study group and control group,with an average age of(66.38±12.12)years vs.(49.35±9.60)years old.The levels of miR-223 and FoxO3 a were detected by enzyme-linked immunosorbent assay(ELISA).The relationship between plasma miR-223 and FoxO3 a with the left atrium(LA),right atrium(RA),left ventricular end diastolic volume(EDV),left ventricular end systolic volume(ESV),interventricular septum(IVS),right ventricular outflow tract(RVOT),right ventricular(RV),pulmonary artery pressure(PAP),color kinesis(CK),diastolic mitral antegrade flow peak E(MV-E),diastolic mitral antegrade flow peak A(MV-A),and ejection fraction(EF)were analyzed.Results There were significant differences in age and hypertension between the two groups(t=6.954,χ^(2)=12.014,P=0.000,0.001 respectively).In the study group,mi R-223[(0.415±0.065)ng/L vs.(0.309±0.057)ng/L]and Fox O3 a[(0.402±0.058)ng/L vs.(0.306±0.059)ng/L]were significantly higher than the control group,and the difference was statistically significant(P<0.05).There was a positive correlation between the levels of mi R-223 and Fox O3 a(r=0.485,P=0.000).The correlation between the levels of mi R-223 and Fox O3 a with coronary heart disease still remained significant after the age became the control variable(r=0.388,P=0.000;r=0.506,P=0.000).The level of mi R-223 was positively correlated with LA,EDV,ESV,RA and CK(r=0.358,0.338,0.339,0.282,0.274,P=0.001,0.002,0.002,0.012,0.015).Fox O3 a level was positively correlated with LA,EDV,ESV and CK(r=0.302,0.312,0.373,P=0.007,0.005,0.001),and negatively correlated with EF(r=-0.275,-0.278,P=0.014,0.013).Conclusion The plasma levels of mi R-223 and Fox O3 a both are significantly increased in the patients with coronary heart disease,showing a high expression state,and have a certain correlation with the changes of the cardiac structure.