环状RNA cSMARCA5在急性心肌梗死患者中的表达及临床意义  

Expression and clinical significance of circRNA cSMARCA5 in patients with acute myocardial infarction

作　　者：赵静雯 于海奕[1] 张永珍[1] 高炜[1] Zhao Jingwen;Yu Haiyi;Zhang Yongzhen;Gao Wei(Department of Cardiology and Institute of Vascular Medicine,Peking University Third Hospital,NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,Key Laboratory of Molecular Cardiovascular Science,Ministry of Education,Beijing Key Laboratory of Cardiovascular Receptors Research,Beijing 100191,China)

机构地区：[1]北京大学第三医院心内科,国家卫生健康委心血管分子生物学与调节肽重点实验室,分子心血管学教育部重点实验室,心血管受体研究北京市重点实验室,北京100191

出　　处：《中华医学杂志》2023年第12期901-906,共6页National Medical Journal of China

基　　金：国家重点研发计划(2017YFC0908701)

摘　　要：目的探讨环状RNA cSMARCA5在急性心肌梗死(AMI)患者外周血中的表达水平及临床意义。方法本研究为病例对照研究,纳入2021年9—12月于北京大学第三医院心内科就诊的AMI患者100例,按照1∶1匹配的原则,纳入同期经临床及冠状动脉造影除外冠心病的对照组患者100例。采用实时荧光定量聚合酶链式反应(RT-qPCR)检测AMI组和对照组患者外周血中cSMARCA5的表达量。利用受试者工作特征(ROC)曲线计算cSMARCA5对AMI的诊断能力,分析cSMARCA5与炎症指标、心肌损伤标志物、冠状动脉病变评分和全球急性冠状动脉事件注册研究(GRACE)评分的相关性。通过生物信息学分析预测cSMARCA5在AMI病理改变中可能涉及的作用机制。结果AMI患者和对照组患者的年龄[M(Q1,Q3)]分别为63.0(56.0,71.5)和63.0(53.0,75.5)岁(P=0.622),男性占比分别为75.0%(75例)和46.0%(46例)(P<0.001)。AMI患者外周血cSMARCA5表达水平[M(Q1,Q3)]低于对照组[0.37(0.22,0.73)比1.03(0.71,1.75),P<0.001]。cSMARCA5诊断AMI的曲线下面积为0.83(95%CI:0.77~0.89),灵敏度89.0%,特异度67.7%。cSMARCA5表达量与AMI患者的肌酸激酶同工酶MB峰值(r=-0.203,P=0.041)、肌钙蛋白T峰值(r=-0.230,P=0.023)和N末端脑钠肽前体峰值(r=-0.250,P=0.012)呈负相关,与左室射血分数呈正相关(r=0.201,P=0.042)。cSMARCA5与冠状动脉病变SYNTAX评分(r=-0.196,P=0.048)和GRACE危险分层评分(r=-0.321,P=0.001)呈负相关,与Gensini评分相关性无统计学意义(P>0.05)。生物信息学分析提示,cSMARCA5可能通过调控肿瘤坏死因子基因表达而参与AMI的病理生理过程。结论环状RNA cSMARCA5在AMI患者中表达低于对照组,其表达水平与心肌梗死的严重程度负相关,可能成为AMI的潜在生物标志物。Objective To investigate the expression level and clinical significance of cSMARCA5 in the patients with acute myocardial infarction(AMI).Methods This study was a case-control study.A total of 100 patients with AMI and 100 patients without coronary heart disease who received treatment in the Department of Cardiology,Peking University Third Hospital from September to December 2021 were included in the study according to the principle of 1∶1 frequency matching.The expression levels of cSMARCA5 in the peripheral blood of AMI patients and control groups were measured by real-time quantitative polymerase chain reaction(RT-qPCR).The receiver operating characteristic(ROC)curve was used to calculate the diagnostic ability of cSMARCA5 for AMI.Spearman or Pearson correlation analysis was used to explore the correlation between cSMARCA5 and the degree of myocardial necrosis,coronary lesion severity and GRACE risk stratification score.Bioinformatics analysis was used to predict the possible mechanism of cSMARCA5 in pathological changes of AMI.Results The age[M(Q1,Q3)]of AMI patients and control group was 63.0(56.0,71.5)and 63.0(53.0,75.5)(P=0.622),and the proportion of males was 75.0%(75 cases)and 46.0%(46 cases)(P<0.001),respectively.The expression level[M(Q1,Q3)]of cSMARCA5 was significantly lower in AMI patients compared with the control group[0.37(0.22,0.73)vs 1.03(0.71,1.75),P<0.001].ROC analysis showed that the area under the curve of cSMARCA5 in diagnosing AMI was 0.83(95%CI:0.77-0.89,P<0.001),with a sensitivity of 89.0%and specificity of 67.7%.cSMARCA5 was negatively correlated with creatine kinase isoenzyme MB(r=-0.203,P=0.041),troponin T(r=-0.230,P=0.023)and N-terminal brain natriuretic peptide precursor(r=-0.250,P=0.012),and positively correlated with left ventricular ejection fraction(r=0.201,P=0.042).In addition,the expression level of cSMARCA5 was negatively correlated with SYNTAX score(r=-0.196,P=0.048)and GRACE risk score(r=-0.321,P=0.001).Bioinformatic analysis suggested that cSMARCA5 might be involved in

关 键 词：急性心肌梗死 环状RNA 生物标志物 cSMARCA5 

分 类 号：R542.22[医药卫生—心血管疾病]