急性心肌梗死患者外周血单个核细胞miR-132、单核细胞趋化蛋白-1的表达及与预后的关系  

Expression of miR-132 and monocyte chemoattractant protein-1 in peripheral blood mononuclear cells of patients with acute myocardial infarction and their relationship with prognosis

作　　者：李晶瑾 翟阳 靳刚[3] 陈茜 黄欣[1] LI Jingjin;ZHAI Yang;JIN Gang;CHEN Qian;HUANG Xin(Department of Cardiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xian 710061,Shaanxi,China;Department of Oncology,Tumor hospital of Shaanxi province,Xi'an 710061,Shaanxi,China;Department of Imaging,Xi'an Huashan Central Hospital,Xi'an 710061,Shaanxi,China;Department of Reproductive Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xian 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院心血管内科,陕西西安710061 [2]陕西省肿瘤医院肿瘤内科,陕西西安710061 [3]西安市华山中心医院影像科,陕西西安710061 [4]西安交通大学第一附属医院生殖医学科,陕西西安710061

出　　处：《贵州医科大学学报》2022年第1期106-113,共8页Journal of Guizhou Medical University

基　　金：陕西省2019年重点研发计划(2019SF-164)。

摘　　要：目的探讨急性心肌梗死(AMI)患者外周血单个核细胞(PBMC)miR-132、单核细胞趋化蛋白-1(MCP-1)的表达与左心室重构及预后的关系。方法84例AMI患者作为AMI组、90例非冠心病(NCHD)患者作为NCHD组,AMI组患者根据预后再分为AMI预后不良亚组和预后良好亚组;比较2组患者入院时的临床生化指标[白细胞计数(WBC)、淋巴细胞计数(LYM)、肌酸激酶(CK)、肌酸激酶同工酶(CKMB)、高敏肌钙蛋白T(hs-cTnT)、N-末端脑钠肽前体(NT-proBNP)、甘油三酯(TG)、总胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]和1年随访时左心室重构及左心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左室短轴缩短率(LVFS)及心输出量(CO)],采用密度梯度离心法分离PBMC,通过RT-qPCR检测miR-132和MCP-1的表达,采用Pearson相关分析miR-132与MCP-1的相关性、AMI患者miR-132和MCP-1与心肌损伤标志物、NT-proBNP、左心室重构及功能的相关性;采用受试者工作特征曲线(ROC)分析miR-132和MCP-1对AMI及预后的诊断价值。结果AMI组miR-132、MCP-1、WBC、LYM、CK、CKMB、hs-cTnT、NT-proBNP、TG、CHOL、LDL-C、LVESD、LVEDD均明显高于NCHD组(P<0.01);HDL-C、LVEF、LVFS、CO明显低于NCHD对照组(P<0.01);AMI组MCP-1的表达与miR-132呈正相关(r=0.71,P<0.01),miR-132和MCP-1表达与CK、CKMB、hs-cTnT、NT-proBNP、LVESD、LVEDD呈正相关(P<0.01),与LVEF、LVFS、CO呈负相关(P<0.01);AMI预后不良亚组miR-132、MCP-1、hs-cTnT、NT-proBNP、LVESD、LVEDD明显高于预后良好亚组(P<0.01),LVEF、LVFS、CO明显低于预后良好亚组(P<0.01);miR-132、MCP-1、NT-proBNP、LVESD、LVEDD、LVEF、LVFS为AMI预后的独立危险因素(P<0.05);miR-132、MCP-1预测AMI患者预后不良的曲线下面积(AUC)分别为0.84、0.74,二者联合的AUC为0.85。结论miR-132及MCP-1在AMI患者PBMC中表达升高,与心肌损伤的程度、左室重构及左心功能相关Objective To investigate the association of the expression miR-132 and monocyte chemoattractant protein-1(MCP-1)in peripheral blood mononuclear cells(PBMCs)with left ventricular remodeling and prognosis in patients with acute myocardial infarction(AMI).Methods A total of 84 patients with AMI were taken as AMI group and 90 patients with non-coronary heart disease(NCHD)as NCHD group.The patients in AMI group were further divided into a subgroup with poor prognosis and a subgroup with good prognosis according to the prognosis.Clinical biochemistry indexes of two groups at admission was compared,including white blood cell count(WBC),lymphocyte count(LYM),creatine kinase(CK),creatine kinase isoenzyme(CKMB),high-sensitivity troponin T(hs-cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP),triglycerides(TG),total cholesterol(CHOL),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),left ventricular remodeling,and left ventricular function indicators at the 1-year follow-up.Detected left ventricular function indicators included left ventricular end systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),left ventricular short axis shortening rate(LVFS),and cardiac output(CO).PBMCs were isolated by density gradient centrifugation.Expression levels of miR-132 and MCP-1 were detected by RT-qPCR.Pearson correlation was used to analyze the association of miR-132 with MCP-1 and the association of miR-132 and MCP-1 with myocardial injury markers,NT-proBNP,left ventricular remodeling and functions.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic values of miR-132 and MCP-1 for AMI and prognostic values.Results miR-132,MCP-1,WBC,LYM,CK,CKMB,hs-cTnT,NT-proBNP,TG,CHOL,LDL-C,LVESD,LVEDD in AMI group were significantly higher than those in NCHD group(P<0.01),while HDL-C,LVEF,LVFS,and CO in AMI group were significantly lower than those in NCHD group(P<0.01).MCP-1 expression in AMI group was positively correla

关 键 词：急性心肌梗死 外周血单个核细胞 miR-132 单核细胞趋化蛋白-1 心室重构 

分 类 号：R541.4[医药卫生—心血管疾病]