冠心病心绞痛患者外周血中内皮祖细胞miR-21、miR-145表达与并发心力衰竭的关系

Relationship between the Expression of MiR-21 and MiR-145 in Peripheral Blood Endothelial Progenitor Cells and Heart Failure in Patients with Coronary Heart Disease and Angina Pectoris

目的 探讨冠心病心绞痛患者外周血中内皮祖细胞微小核糖核酸-21(miR-21)、微小核糖核酸-145(miR-145)表达与并发心力衰竭的关系。方法 选取2019年3月至2021年12月接受经皮冠脉介入术(percutaneous coronary intervention,PCI)的180例冠心病心绞痛患者作为疾病组,另选取同期进行体检的健康人群150例作为健康组。采用定量逆转录聚合酶链式反应(quantitative reverse transcription polymerase chain reaction,qRT-PCR)检测两组外周血中内皮祖细胞miR-21、miR-145表达水平。另根据患者出院后12个月随访期间是否并发心力衰竭将疾病组患者分为并发心力衰竭组及未并发心力衰竭组,比较两组患者外周血中内皮祖细胞miR-21、miR-145表达水平。采用多因素logistic回归分析冠心病心绞痛患者外周血中内皮祖细胞miR-21、miR-145表达与并发心力衰竭的关系。结果 疾病组miR-21表达水平高于健康组(P <0.05),miR-145表达水平低于健康组(P <0.05)。随访12个月后,180例冠心病心绞痛患者中并发心力衰竭42例,并发率为23.33%;并发心力衰竭组糖尿病、高甘油三酯血症患者占比和hs-CRP、miR-21表达水平均高于未并发心力衰竭组(P <0.05),miR-145表达水平低于未并发心力衰竭组(P <0.05)。多因素logistic回归分析结果显示,在未校正因素时,miR-21表达水平是冠心病心绞痛患者并发心力衰竭的危险因素,miR-145是其保护因素(OR=3.012、3.233,P <0.05),校正全因素后miR-21仍是冠心病心绞痛患者并发心力衰竭的危险因素,miR-145是其保护因素(OR=1.589、1.634,P <0.05)。结论 冠心病心绞痛患者外周血中内皮祖细胞miR-21表达水平高于健康人群,miR-145表达水平低于健康人群,且外周血中内皮祖细胞miR-21是影响冠心病心绞痛并发心力衰竭的危险因素,而miR-145是其保护因素。

Objective To investigate the relationship between the expression of microRNA-21(miR-21) and microRNA-145(miR-145) in peripheral blood endothelial progenitor cells and heart failure in patients with coronary heart disease and angina pectoris.Methods A total of 180 patients with coronary heart disease and angina pectoris who underwent percutaneous coronary intervention(PCI) from March 2019 to December 2021 were selected as the disease group,while 150 healthy people who underwent physical examination in the physical examination center of our hospital in the same period were selected as the health group.The expression levels of miR-21 and miR-145 in endothelial progenitor cells in peripheral blood of the two groups were detected and compared by realtime fluorescence quantitative polymerase chain reaction(qRT-PCR).In addition,the patients in the disease group were divided into complicated heart failure group and non complicated heart failure group according to whether they were complicated with heart failure during the 12-month follow-up after discharge,and the expression levels of miR-21 and miR-145 in endothelial progenitor cells in peripheral blood of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the relationship between the expression of miR-21 and miR-145 in peripheral blood of patients with coronary heart disease and angina pectoris and heart failure.Results The expression level of miR-21 in the disease group was higher than that in the healthy group(P < 0.05),and the expression level of miR-145 was lower than that in the healthy group(P < 0.05).Among 180 patients with coronary heart disease and angina pectoris,42 cases were complicated with heart failure,and the complication rate was 23.33% after follow-up for 12 months.The heart failure group the proportions of diabetes,hypertriglyceridemia and the expression levels of hs-CRP,miR-21 were higher than those of the non heart failure group(P < 0.05),while the miR-145 expression level was lower than that of the non heart failure group(P < 0.05).The results of multivariate logistic regression analysis showed that when the factors were not adjusted,the expression level of miR-21 was a risk factors of heart failure in patients with coronary heart disease and angina pectoris,and miR-145 was its protective factor(OR =3.012,3.233,P < 0.05),and after adjusting for all factors,miR-21 was still a risk factor of heart failure in patients with coronary heart disease and angina pectoris,and miR-145 was its protective factor(OR=1.589,1.634,P < 0.05).Conclusion The expression level of miR-21 in peripheral blood endothelial progenitor cells of patients with coronary heart disease and angina pectoris is higher than that in healthy people,and the level of miR-145 expression is lower than that in healthy people.The miR-21 in peripheral blood endothelial progenitor cells is a risk factors that affect coronary heart disease and angina pectoris and heart failure,and miR-145 is the protective factor.