LncRNACoroMarker在急性心肌梗死患者外周血单核细胞中的表达及意义

Expression and significance of LncRNA-CoroMarker in peripheral blood mononuclear cells in patients with acute myocardial infarctio

目的 通过检测急性ST段抬高型心肌梗死(STEMI)患者外周血单核细胞(PBMCs)中LncRNA CoroMarker和血浆单核细胞趋化蛋白-1 (MCP-1)的表达水平,分析CoroMarker在STEMI中的生物意义。方法 连续选取2020年7月至2021年1月于广东省韶关市粤北人民医院心血管内科住院确诊为STEMI的患者50例作为实验研究对象(STEMI组),另选取在本院体检中心同时期健康体检的无冠心病人群50例作为对照组。所有研究对象入院即刻抽血,分离外周血单核细胞(PBMCs)和血浆,qRT-PCR法检测PBMCs中CoroMarker的表达水平,ELISA法检测血浆MCP-1水平。收集所有研究对象一般临床资料、生化指标和1年内主要不良心血管事件(MACE)。结果 与对照组比较,CoroMarker在STEMI组患者PBMCs中相对表达量显著下降(P<0.01),而血浆MCP-1水平在STEMI中表达显著升高(P=0.032),两者有显著负相关性(P<0.01)。CoroMarker诊断STEMI的ROC曲线下面积为0.806 (95%CI:0.705~0.920,P<0.01),敏感度和特异性分别为75.0%和76.7%,cut-off值为CT值12.02。多因素Cox回归分析显示CoroMarker是STEMI患者住院期间发生MACE的保护性因子(HR=0.28,95%CI:0.08~0.96,P=0.042),但与出院1年内发生MACE无明显相关性(HR=0.78,95%CI:0.47~1.29,P=0.326)。结论 LncRNA CoroMarker可作为STEMI的诊断生物标志物,具有预测STEMI患者住院期间发生MACE的作用,可能通过调控相关炎性因子参与STEMI的发病过程。

Objective To analyze the biological significance of CoroMarker in ST-segment elevation myocardial infarction(STEMI)through detecting the expressions of long noncoding RNA(LncRNA)CoroMarker and plasma monocyte chemotactic protein 1(MCP-1)in STEMI patients.Methods STEMI patients(n=50)were chosen into STEMI group,and meanwhile the cases(n=50)without coronary heart disease(CHD)were chosen into control group from Department of Cardiovascular Medicine in Yue Bei People's Hospital of Shaoguan City from July 2020 to Jan.2021.The blood samples were collected from all cases immediately after admission for separating peripheral blood mononuclear cells(PBMCs)and plasma.The expression of CoroMarker in PBMCs was detected by using qRT-PCR,and level of plasma MCP-1 was detected by using ELISA.The general clinical materials,biochemical indexes and incidence of major adverse cardiovascular events(MACE)within 1 y were collected and observation in 2 groups.Results The expression level of CoroMarker in PBMCs decreases significantly(P<0.01),and level of MCP-1 increases significantly(P=0.032)in STEMI group compared with control group,and CoroMarker was negatively correlated to MCP-1(P<0.01).In the diagnosis of STEMI with CoroMarker,the AUC of ROC curve was 0.806(95%Cl:0.705~0.920,P<0.01),sensitivity was 75.0%,specificity was 76.7%,and cutoff value was 12.02.The results of Cox regression analysis showed that CoroMarker was a protective factor of MACE occurrence in STEMI patients during hospitalization period(HR=0.28,95%CI:0.08~0.96,P=0.042),but had no significant correlation to MACE occurrence within 1 y after discharged(HR=0.78,95%CI:0.47~1.29,P=0.326).Conclusion LncRNA CoroMarker can be taken as a biomarker for STEMI diagnosis,which can predict MACE occurrence in STEMI patients during hospitalization period,and participate in STEMI pathogenesis through controlling relative inflammatory factors..