急性STEMI患者外周血miR-495表达水平与血常规炎症标志物的相关性及其与PCI术后无复流的关系  

Relationship among miR-495 expression level,blood routine inflammatory markers and postoperative no reflow in patients with acute STEMI

作　　者：赵轶超 刘洋洋 王文龙 张由建[2] Zhao Yichao;Liu Yangyang;Wang Wenlong;Zhang Youjian(First Department of Cardiology,Sixth People's Hospital of Luohe City,Luohe 462000,China.;不详)

机构地区：[1]漯河市第六人民医院心内一科,漯河462000 [2]河南省胸科医院心内科一病区,郑州450000

出　　处：《中国循证心血管医学杂志》2023年第1期76-80,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河南省医学科技攻关计划项目(2018020566)。

摘　　要：目的研究ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术前外周血miR-495表达水平与血常规炎症标志物的相关性及其与术后无复流的关系。方法选择2017年6月至2020年6月期间于漯河市第六人民医院成功接受急诊PCI的STEMI患者,根据PCI术后TIMI血流分级分为TIMI 0~1级的无复流组(n=19)、TIMI 2~3级的血流正常组(n=143)。比较两组间临床资料及外周血miR-495表达水平的差异,采用Pearson检验分析miR-495表达水平与炎症指标中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统性免疫性炎症指数(SII)的相关性,采用ROC曲线分析术前不同指标对术后无复流的预测价值,采用Logistic回归模型分析术后无复流的影响因素。结果无复流组的Gensini积分及术前NLR、PLR、SII水平均高于血流正常组,外周血miR-495表达水平均低于血流正常组(P<0.05);经Pearson检验分析,无复流组患者miR-495表达水平与NLR、PLR、SII水平呈负相关(P<0.05);经ROC曲线分析,miR-495、NLR、PLR、SII对术后无复流具有预测价值,曲线下面积分别为;经Logistic回归分析,miR-495是术后无复流的影响因素。结论术前外周血miR-495表达水平降低与STEMI患者炎症反应激活及PCI后无复流有关,术前检测miR-495是预测无复流的理想指标。Objective To study the correlation among expression level of microRNA-495(miR-495)in peripheral blood,blood routine inflammatory markers and postoperative no reflow in patients with acute ST-segment elevation myocardial infarction(STEMI)undergone emergency percutaneous coronary intervention(PCI).Methods The patients with acute STEMI received emergency PCI were chosen from the Sixth People’s Hospital of Luohe City from June 2017 to June 2020.All patients were divided,according to post-PCI TIMI flow grades,into no reflow group(TIMI grade 0~1,n=19)and normal flow group(TIMI grade 2~3,n=143).The clinical materials and expression level of miR-495 were compared between 2 groups.The correlation between expression level of miR-495 and inflammatory indexes including neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and systemic immune inflammation index(SII)was analyzed by using Pearson test.The predictive value of preoperative indexes to postoperative no reflow was analyzed by using ROC curve,and influence factors of postoperative no reflow were analyzed by using Logistic regression model.Results The Gensini integrals and preoperative levels of NLR,PLR and SII were higher,and expression level of miR-495 was lower in no reflow group than those in normal flow group(P<0.05).The results of Pearson test analysis showed that expression level of miR-495 was negatively correlated to levels of NLR,PLR and SII in no reflow group(P<0.05).The results of ROC curve analysis showed that miR-495,NLR,PLR and SII had predictive value to postoperative no reflow,and the area under ROC curve was,respectively,0.9093(95%CI:0.8483~0.9703,P<0.001),0.6503(95%CI:0.5112~0.7895,P=0.034),0.6846(95%CI:0.5733~0.7958,P=0.009)and 0.6629(95%CI:0.4969~0.8288,P=0.021).The results of Logistic regression analysis showed that miR-495 was an influence factor of postoperative no reflow.Conclusion The preoperative decrease of miR-495 expression in peripheral blood is correlated to activation of inflammatory responses and post-PCI no reflow in

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入治疗 miR-495 炎症反应 

分 类 号：R542.22[医药卫生—心血管疾病]