急性冠状动脉综合征患者血清miR-27a、miR-34a表达及其临床意义  

Expression of Serum miR-27 a and miR-34 a in Patients with Acute coronary Syndrome and Its Clinical Significance

作　　者：王磊[1] 夏云峰[1] 李良[1] 王晨[1] WANG Lei;XIA Yunfeng;LI Liang;WANG Chen(Department One of Cadre Ward,the Fourth Medical Center of PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军总医院第四医学中心干一科

出　　处：《医学综述》2019年第15期3096-3100,3105,共6页Medical Recapitulate

摘　　要：目的探讨急性冠状动脉综合征(ACS)患者血清miR-27a、miR-34a表达及其与冠状动脉病变程度的相关性。方法选取2016年7月至2018年2月在解放军总医院第四医学中心进行冠状动脉造影术的患者为研究对象,其中ACS患者86例(ACS组)、稳定型心绞痛(SAP)患者70例(SAP组),另外同期选取72例体检健康志愿者为对照组。根据SYNTAX评分标准将ACS患者分为轻度病变组(22例)、中度病变组(27例)、重度病变组(37例)。采用实时荧光定量聚合酶链反应法检测各组血清miR-27a、miR-34a表达水平,并采用Pearson法分析ACS患者血清miR-27a、miR-34a与ACS患者临床指标的相关性。采用Logistic回归分析ACS患者冠状动脉病变程度的影响因素。结果与对照组相比,SAP组与ACS组患者血清miR-27a、miR-34a表达水平升高(P<0.05),且ACS组高于SAP组(P<0.05);Pearson分析显示miR-27a、miR-34a表达呈正相关(r=0.492,P<0.05),且均与总胆固醇、糖化血红蛋白、高敏C反应蛋白呈正相关(r=0.413,0.536,0.415;r=0.276,0.395,0.274,P<0.05),而与高密度脂蛋白胆固醇呈负相关(r=-0.560,-0.372,P<0.05);与轻度病变组相比,重度病变组与中度病变组ACS患者血清miR-27a、miR-34a表达水平显著升高(2.23±0.37、1.85±0.62比1.22±0.20;2.20±0.37、1.61±0.27比1.35±0.23,P<0.05),且重度病变组显著高于中度病变组(P<0.05);Logistic回归分析结果显示,miR-27a(OR=2.225,95%CI1.812~2.732,P=0.031)、miR-34a(OR=2.072,95%CI1.629~2.635,P=0.022)均为ACS患者冠状脉病变的影响因素。结论ACS患者血清miR-27a、miR-34a呈高表达,并与冠状动脉病变程度密切相关,且均可作为临床预测冠状动脉病变的重要指标。Objective To investigate the expressions of microRNA-27a(miR-27a)and microRNA-34a(miR-34a)in serum of patients with acute coronary syndrome(ACS)and their correlations with the degree of coronary artery disease.Methods Patients who underwent coronary angiography in the Fourth Medical Center of PLA General Hospital from Jul.2016 to Feb.2018 were included,among them,86 were ACS patients(group ACS)and 70 were stable angina(SAP)patients(group SAP),another 72 healthy volunteers during the same period were included as a control group.According to the SYNTAX score,the ACS patients were divided into a mild lesion group(22 cases),a moderate lesion group(27 cases)and a severe lesion group(37 cases).The expression levels of miR-27a and miR-34a in each group were detected by quantitative real-time polymerase chain reaction,and Pearson method was used to analyze miR-27a,miR-34a and their correlations with clinical indicators of ACS patients.Logistic method was used for regressive analysis on the influencing factors of coronary artery lesion in ACS patients.Results Compared with the control group,the levels of serum miR-27a and miR-34a in the SAP group and ACS group were significantly higher(P<0.05),and the ACS group was significantly higher than SAP group(P<0.05);Pearson analysis showed a significant positive correlation between miR-27a and miR-34a(r=0.492,P<0.05),and they were significantly positively correlated with total cholesterol,glycosylated hemoglobin,high sensitive C-reactive protein(r=0.413,0.536,0.415;r=0.276,0.395,0.274,P<0.05),and were significantly negatively correlated with high density lipoprotein cholesterol(r=-0.560,-0.372,P<0.05);compared with the mild lesion group,levels of serum miR-27a and miR-34a in the severe lesion group and moderate lesion group were significantly higher(2.23±0.37,1.85±0.62 vs 1.22±0.20;2.20±0.37,1.61±0.27 vs 1.35±0.23,P<0.05),and the severe lesion group was significantly higher than the moderate lesion group(P<0.05);Logistic analysis showed that the expressions of miR-27a(OR=2.

关 键 词：急性冠状动脉综合征 miR-27a MIR-34A 冠状动脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]