老年急性冠状动脉综合征患者微小RNA-27a和微小RNA-186-5p与心室重构的关系  

Relationship of miR-27a and miR-186-5p expressions with ventricular remodeling in elderly acute coronary syndrome patients

作　　者：余成[1] 吴丹娜[2] 洪萍[1] 庄仁玮 曾星 吴小波[3] Yu Cheng;Wu Danna;Hong Ping;Zhuang Renwei;Zeng Xing;Wu Xiaobo(Department of Cardiosurgery,Hainan Provincial People􀆳s Hospital,Haikou 570311,Hainan Province,China)

机构地区：[1]海南省人民医院心外科,海口570311 [2]海南省人民医院药学部,海口570311 [3]海南省人民医院心内科,海口570311

出　　处：《中华老年心脑血管病杂志》2021年第3期256-259,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年急性冠状动脉综合征(ACS)患者血清微小RNA(miR)-27a、miR-186-5p的表达及其与心室重构、主要不良心血管事件(MACE)的关系。方法选择我院就诊的220例ACS患者,根据术后1年随访是否发生MACE分为MACE组(78例)和非MACE组(142例),通过检测平均室壁应力(MWS),相对室壁厚度(RWT)、左心室质量指数(LVMI)评估左心室重构程度,检测2组外周静脉血清miR-27a、miR-186-5p的表达,用Pearson相关性分析miR-27a、miR-186-5p与心室重构的相关性,多元logistic回归分析MACE的危险因素。结果2组空腹血糖、TC、HDL-C、高敏C反应蛋白(hs-CRP)比较差异有统计学意义(P<0.05,P<0.01)。MACE组miR-27a、miR-186-5p表达高于非MACE组(P<0.01)。miR-27a、miR-186-5p的ROC曲线下面积分别为0.707、0.657,敏感性分别为79.49%、58.97%,特异性分别为59.86%、75.35%。MACE组LVMI、MWS、RWT均显著高于非MACE组(P<0.01);miR-27a、miR-186-5p与LVMI、MWS、RWT均呈正相关(P<0.05,P<0.01)。多元logistic回归分析显示,hs-CRP、miR-27a、miR-186-5p、LVMI、MWS、RWT是发生MACE的独立危险因素(P<0.05,P<0.01)。结论老年ACS患者血清miR-27a、miR-186-5p与心室重构呈正相关,两者均是MACE的独立危险因素。Objective To study the relationship of microRNA(miR)-27a and miR-186-5p expressions with ventricular remodeling and MACE in elderly acute coronary syndrome(ACS)patients.Methods Two hundred and twenty elderly ACS patients admitted to our hospital from January 2017 to January 2019 were divided into MACE group(n=78)and MACE-free group(n=142).Their left ventricular remodeling was evaluated by measuring the mean wall stress(MWS),relative wall thickness(RWT)and left ventricular mass index(LVMI).The expressions of miR-27a and miR-186-5p in peripheral venous blood were detected.The relationship of miR-27a and miR-186-5p expressions with ventricular remodeling was analyzed by Pearson correlation analysis.The risk factors for MACE in elderly ACS patients were analyzed by multivariate logistic regression analysis.Results Significant difference was detected in serum levels of fasting blood glucose,TC,HDL-C and hs-CRP between the two groups(P<0.05,P<0.01).The expression levels of miR-27a and miR-186-5p were significantly higher in MACE group than in MACE-free group(P<0.01).The AUC for miR-27a and miR-186-5p in predicting ventricular remodeling and MACE in elederly ACS patients was 0.707 and 0.657 respectively with a sensitivity of 79.49%and 58.97%respectively,and a specificity of 59.86%and 75.35%respectively.The LVMI and MWS were significantly higher and the RWT was significantly thicker in MACE group than in MACE-free group(P<0.01).Pearson correlation analysis showed that the miR-27a and miR-186-5p expressions were positively related with the LVMI,MWS and RWT in elderly ACS patients(P<0.05,P<0.01).Multivariate logistic regression analysis displayed that hs-CRP,miR-27a,miR-186-5p,LVMI,MWS and RWT were the independent risk factors for MACE in elderly ACS patients(P<0.05,P<0.01).Conclusion Serum miR-27a and miR-186-5p levels are positively related with ventricular remodeling and are the independent risk factors for MACE in elderly ACS patients.

关 键 词：急性冠状动脉综合征 心室重构 基因表达调控 

分 类 号：R541.4[医药卫生—心血管疾病]