血清长链非编码RNA核富集转录体1及可溶性细胞间黏附分子1水平与冠状动脉慢血流现象的关系

Relationship of serum levels of long non-coding RNA nuclear enriched abundant transcript 1 and soluble intercellular adhesion molecule-1 with coronary slow flow phenomenon

目的 探讨血清长链非编码RNA核富集转录体1(NEAT1)及可溶性细胞间黏附分子1(sICAM-1)水平与冠状动脉慢血流现象(CSFP)的关系。方法 选择2020年8月至2022年2月在四川省遂宁市中心医院疑诊为冠状动脉粥样硬化性心脏病而行冠状动脉造影检查的患者,以其中造影未见明显病变的110例为研究对象,将心肌梗死溶栓试验(TIMI)血流分级2级及以下且无冠状动脉狭窄、诊断为CSFP的70例患者作为CSFP组,以TIMI血流分级3级且无冠状动脉明显狭窄者40例作为对照组。利用荧光定量聚合酶链反应法检测血清NEAT1表达,酶联免疫吸附试验法检测血清sICAM-1表达。比较2组NEAT1及sICAM-1表达差异。Pearson线性相关分析方法分析血清NEAT1及sICAM-1水平与冠状动脉TIMI平均血流帧数的相关性。采用多因素Logistic回归方法分析CSFP的危险因素。采用受试者工作特征曲线分析血清NEAT1、sICAM-1单独及联合检测对CSFP的诊断效能。结果 CSFP组血清NEAT1、sICAM-1表达水平高于对照组,差异均有统计学意义(均P<0.05)。Pearson相关性分析结果显示,血清NEAT1、sICAM-1表达与冠状动脉TIMI平均血流帧数呈显著正相关(r=0.456、0.503,均P<0.001)。血清NEAT1与sICAM-1的表达水平呈显著正相关(r=0.541,P<0.001)。有吸烟史、血清NEAT1、sICAM-1水平升高是CSFP的独立危险因素,白蛋白升高是CSFP的保护因素(均P<0.05)。血清NEAT1、sICAM-1单独及联合检测诊断CSFP的曲线下面积分别为0.698(95%置信区间:0.591~0.736)、0.789(95%置信区间:0.734~0.832)、0.836(95%置信区间:0.802~0.885),联合检测诊断CSFP的曲线下面积显著高于血清NEAT1、sICAM-1单独检测(Z=2.061、P=0.039,Z=6.403、P<0.001)。结论 CSFP患者血清NEAT1、sICAM-1水平升高。有吸烟史、血清NEAT1、sICAM-1水平升高是CSFP的独立危险因素,白蛋白升高是CSFP的保护因素。血清NEAT1、sICAM-1联合检测对CSFP具有较高的诊断价值。

Objective To investigate the relationship of serum levels of long non-coding RNA nuclear enriched abundant transcript 1(NEAT1) and soluble intercellular adhesion molecule-1(sICAM-1) with coronary slow flow phenomenon(CSFP). Methods From August 2020 to February 2022, 110 patients with suspected coronary atherosclerotic heart disease and undergoing coronary angiography in Suining Central Hospital, Sichuan Province were selected as study subjects. Of which 70 patients with thrombolysis in myocardial infarction(TIMI) blood flow grade 2 or below, no coronary stenosis and diagnosis of CSFP were selected as the CSFP group, another 40 patients with TIMI blood flow grade 3 and no obvious coronary stenosis were selected as the control group. The expression of serum NEAT1 was detected by fluorescence quantitative polymerase chain reaction, and the expression of serum sICAM-1 was detected by enzyme-linked immunosorbent assay. The expressions of NEAT1 and sICAM-1 between the two groups were compared. Pearson linear correlation analysis was used to analyze the correlation of serum levels of NEAT1, sICAM-1 with the average flow frames of TIMI. Multivariate Logistic regression method was used to analyze the risk factors of CSFP. The receiver operating characteristic curve was used to analyze the diagnostic efficacy of serum NEAT1 and sICAM-1 alone and in combination for CSFP. Results Compared with the control group, the expressions of serum NEAT1 and sICAM-1 in CSFP group were significantly higher(both P<0.05). Pearson correlation analysis showed that the expressions of serum NEAT1 and sICAM-1 were significantly positively correlated with the average blood flow frames of TIMI(r=0.456, 0.503, both P<0.001). There was a significant positive correlation between the expression of serum NEAT1 and sICAM-1(r=0.541, P<0.001). Smoking history, the increase of serum NEAT1 and sICAM-1 were independent risk factors of CSFP, and the increase of albumin was a protective factor of CSFP(all P<0.05). The areas under the curve of serum NEAT1 and sICAM-1 alone and in combination for the diagnosis of CSFP were 0.698(95% confidence interval: 0.591-0.736), 0.789(95% confidence interval: 0.734-0.832) and 0.836(95% confidence interval: 0.802-0.885), respectively. The area under the curve of serum NEAT1 and sICAM-1 in combination for the diagnosis of CSFP was significantly higher than those alone(Z=2.061, P=0.039;Z=6.403, P<0.001). Conclusions The serum levels of NEAT1 and sICAM-1 increase in CSFP patients. Smoking history, elevated serum levels of NEAT1 and sICAM-1 are independent risk factors for CSFP, and elevated albumin is a protective factor for CSFP. The detection of serum NEAT1 and sICAM-1 in combination has high diagnostic value for CSFP.