外周血单个核细胞miR-150表达对STEMI患者PCI术后发生左心室重构的预测价值  

Predictive value of PBMCs miR-150 for left ventricular remodeling after STEMI treated with PCI

作　　者：高红霞[1] 杨彩霞[1] 任刚[1] GAO Hongxia;YANG Caixia;REN Gang(Department of Cardiovascular Medicine,Tieling Central Hospital,Tieling 112000,China)

机构地区：[1]铁岭市中心医院心内科,辽宁铁岭112000

出　　处：《东南大学学报（医学版）》2021年第2期170-175,共6页Journal of Southeast University(Medical Science Edition)

基　　金：辽宁省科学技术计划项目(2018205020)。

摘　　要：目的:探讨外周血单个核细胞(PBMCs)中miR-150表达对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后发生左心室重构(LVR)的预测价值。方法:选取2018年3月至2019年1月在我院接受急诊PCI术的STEMI患者165例,术后随访1年,复查超声心动图,左室舒张末期容积(LVEDV)比出院时增加≥20%则定义为LVR。根据超声心动图复查结果将患者分为LVR组和非LVR组。采用实时荧光定量PCR法测定PBMCs中miR-150表达,用双荧光素酶报告基因分析C反应蛋白(CRP)mRNA与miR-150的靶向结合关系。结果:35例患者发生LVR,LVR发生率为21.21%。LVR组患者PCI术后7 d PBMCs中miR-150相对表达量低于非LVR组(P<0.05)。多因素Logistic回归分析显示,PBMCs中miR-150表达是STEMI患者PCI术后发生LVR的独立预测因素(OR=0.230,95%CI 0.079~0.584,P<0.05)。经受试者工作特征(ROC)曲线分析,PCI术后7 d PBMCs中miR-150表达预测LVR的曲线下面积(AUC)为0.903(95%CI 0.858~0.948),大于单独使用左室射血分数(LVEF)的AUC(P<0.05)。双荧光素酶报告基因分析显示,miR-150类似物抑制了CRP-3′UTR-WT的荧光素酶活性(P<0.05)。结论:PCI术后7 d PBMCs中miR-150表达是STEMI患者1年内发生LVR的独立预测因子,这可能与诱导CRP表达上调有关。Objective:To explore the predictive value of miR-150 in peripheral blood mononuclear cells(PBMCs)for left ventricular remodeling(LVR)after ST-segment elevation myocardial infarction(STEMI)treated with percutaneous coronary intervention(PCI).Methods:A total of 165 STEMI patients underwent emergency PCI in our hospital from March 2018 to January 2019 were followed up for 1 year.LVR was defined as an increase in left ventricular end-diastolic volume(LVEDV)of more than 20%over the baseline value according to the echocardiography.Patients were divided into LVR group and non-LVR group.The expression of miR-150 in PBMCs was determined by real-time fluorescent quantitative PCR,and the binding of C-reactive protein(CRP)mRNA to miR-150 was analyzed by double luciferase reporter gene.Results:The incidence of LVR was 21.21%(35/165)after 1 year follow up.The relative expression of miR-150 in PBMCs at 7 d after PCI was lower in LVR group than that in non-LVR group(P<0.05).The expression of miR-150 in PBMCs was an independent predictor of postoperative LVR in STEMI patients(OR=0.230,95%CI 0.079-0.584,P<0.05).By receiver operating characteristic(ROC)curve analysis,the area under curve(AUC)of miR-150 expression in PBMCs at 7 d after PCI predicting LVR was 0.903(95%CI 0.858-0.948),and higher than AUC of left ventricular ejection fraction(LVEF)alone(P<0.05).Luciferase reporter gene analysis showed that miR-150 mimics inhibited the luciferase activity of CRP-3′UTR-WT(P<0.05).Conclusion:The expression of miR-150 in PBMCs at 7 d after PCI is an independent predictor of the development of LVR in STEMI patients within 1 year,it may be related with up-regulating CRP expression.

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入 左心室重构 miR-150 炎症 

分 类 号：R542.2[医药卫生—心血管疾病]