冠心病患者微小RNA及外周血T细胞表达对斑块稳定性的影响

Effects of microRNA and peripheral blood T cell expression on plaque stability in patients with coronary heart disease

目的探讨冠心病患者微小RNA-126(miR-126)、微小RNA-221(miR-221)、微小RNA-155(miR-155)及外周血T细胞表达对斑块稳定性的影响。方法选取2019年2月至2020年6月间本院心内科收治的冠心病患者138例,根据血管内超声评价斑块性质,分为稳定斑块组56例,不稳定斑块组82例。另收集同期健康志愿者60例为对照组。实时荧光定量PCR技术检测血浆miR-126、miR-221、miR-155相对表达量;细胞内染色的流式细胞术测定CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞占CD4^(+)细胞的比例;全自动生化分析仪检测血脂4项,酶联免疫吸附法检测血清γ干扰素(IFN-γ)水平。结果与对照组比较,稳定斑块组、不稳定斑块组患者miR-126表达水平明显降低,miR-221、miR-155表达水平明显升高,差异有统计学意义(P<0.05);不稳定斑块组患者miR-126表达水平明显低于稳定斑块组,miR-221、miR-155表达水平明显高于稳定斑块组,差异有统计学意义(P<0.05)。与对照组相比,稳定斑块组、不稳定斑块组患者CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞占CD4^(+)细胞的比例明显降低,血清IFN-γ水平明显升高,差异有统计学意义(P<0.05);不稳定斑块组患者CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞占CD4^(+)细胞的比例明显低于稳定斑块组,血清IFN-γ水平明显高于稳定斑块组,差异有统计学意义(P<0.05)。与对照组相比,稳定斑块组、不稳定斑块组患者总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平明显升高,高密度脂蛋白胆固醇水平明显降低,差异有统计学意义(P<0.05)。冠心病患者miR-126表达水平与总胆固醇、低密度脂蛋白胆固醇水平呈负相关,与CD4^(+)CD25^(+)Foxp3调节性T细胞占CD4^(+)细胞的比例呈正相关。冠心病患者miR-221、miR-155表达水平与总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平呈正相关,与CD4^(+)CD25^(+)Foxp3调节性T细胞占CD4^(+)细胞比例呈负相关。结论miR-126、miR-221、miR-155表达水平与冠心病患者冠脉斑块稳定性、CD4^(+)调节性T细胞表达、血脂水平密切相关。

Objective To investigate the effects of miR-126,miR-221,miR-155and peripheral blood T cell expression on plaque stability in patients with coronary heart disease.Methods 138patients with coronary heart disease treated in the Department of Cardiology of our hospital from February 2019to June 2020were selected.According to the nature of plaque evaluated by intravascular ultrasound,they were divided into stable plaque group(56cases)and unstable plaque group(82cases).Another 60healthy volunteers were collected as the control group.The relative expressions of miR-126,miR-221and miR-155in plasma were detected by real-time fluorescence quantitative PCR;The proportion of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in CD4^(+)cells was determined by flow cytometry;Four items of blood lipid were detected by automatic biochemical analyzer,and serum was detected by enzyme-linked immunosorbent assayγInterferon(IFN-γ)Level.Results Compared with the control group,the expression levels of miR-126were significantly reduced in the stable and unstable plaque groups,while the expression levels of miR-221and miR-155were significantly increased,with a statistically significant difference(P<0.05);The expression levels of miR-126in unstable plaque group were significantly lower than those in stable plaque group,and the expression levels of miR-221and miR-155 were significantly higher than those in stable plaque group(P<0.05).Compared with the control group,the proportion of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in CD4^(+)cells was significantly reduced in patients with stable and unstable plaques,and the level of serum IFN-γhas significantly increased(P<0.05);The proportion of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in CD4^(+)cells in unstable plaque group was significantly lower than that in stable plaque group,and the serum IFN-γlevel was significantly higher than that in the stable plaque group(P<0.05).Compared with the control group,the levels of total cholesterol,triglycerides,and low-density lipoprotein cholesterol in patients with stable and unstable plaques were significantly increased,the levels of high-density lipoportein cholesterol were significantly reduced,with a statistically significant difference(P<0.05).The expression level of miR-126in patients with coronary heart disease was negatively correlated with the level of total cholesterol and low-density lipoprotein cholesterol,and positively correlated with the proportion of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in CD4^(+)cells.The expression levels of miR-221and miR-155in patients with coronary heart disease were positively correlated with the levels of total cholesterol,triglyceride and low-density lipoprotein cholesterol,and negatively correlated with the proportion of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells in CD4^(+)cells.Conclusion The expression levels of miR-126,miR-221and miR-155 were closely related to coronary plaque stability,CD4^(+)regulatory T cell expression and blood lipid levels in patients with coronary heart disease.