血小板源性微小核糖核酸-126与急性冠脉综合征患者替格瑞洛抗血小板反应性的相关性  

Correlation of platelet-derived microRNA-126 with ticagrelor effect on platelet reactivity in patients with acute coronary syndrome

作　　者：刘雨琪 王子乾 吕超 邹宇婷 吴阳勋 王语嫣 姚妍竹 尹彤 Liu Yuqi;Wang Ziqian;Lyu Chao;Zou Yuting;Wu Yangxun;Wang Yuyan;Yao Yanzhu;Yin Tong(Chinese PLA Medical School,Beijing 100853,China;Institute of Geriatrics of Second Medical Center,National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]中国人民解放军总医院第二医学中心老年医学研究所,国家老年疾病临床医学研究中心,北京100853

出　　处：《中华老年多器官疾病杂志》2025年第3期161-165,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金面上项目(81870262;82170352)。

摘　　要：目的探讨血小板源性微小核糖核酸-126(miR-126)与急性冠脉综合征(ACS)患者替格瑞洛抗血小板反应性的相关性。方法连续募集2019年1月至2020年1月于中国人民解放军总医院住院、接受替格瑞洛抗血小板稳定治疗3 d,并采用血栓弹力图进行二磷酸腺苷(ADP)诱导的血小板抑制率(ADP%)检测的272例ACS患者为研究对象。选择ADP%呈极端高值(49例)和极端低值(49例)的患者分别纳入高抗血小板反应性(HAPR)组和低抗血小板反应性(LAPR)组,提取其外周全血血小板RNA,通过实时荧光定量聚合酶链反应(qPCR)技术对血小板中miR-126的表达量进行检测。采用SPSS 27.0统计软件进行数据分析。根据数据类型,分别采用t检验,Wilcoxon秩和检验或χ2检验进行组件比较。通过Pearson相关分析血小板miR-126与ADP%的相关性。结果HAPR组ADP%显著高于LAPR组[94.50%(92.95%,97.42%)和67.40%(57.00%,75.05%)],血小板源性miR-126的表达量显著高于LAPR组[2.97(0.16,31.37)和1.00(0.17,3.31)],差异有统计学意义(P<0.001)。血小板miR-126与替格瑞洛治疗后ADP%呈正相关(r=0.25;P=0.013)。结论血小板miR-126的表达水平可能影响ACS患者替格瑞洛抗血小板反应性。Objective To investigate the correlation between platelet-derived microRNA-126(miR-126)and antiplatelet responsiveness of ticagrelor in patients with acute coronary syndrome(ACS).Methods A total of 272 ACS patients who received stable antiplatelet treatment with ticagrelor in Chinese PLA General Hospital from January 2019 to January 2020 were recruited continuously.After three days of ticagrelor treatment,thromboelastography(TEG)was applied to detect the adenosine diphosphate(ADP)inhibition(ADP%)with platelet mapping for platelet reactivity.Then,49 patients with high ADP%were assigned into high antiplatelet reactivity(HAPR)group,and 49 ones with low ADP%were into low antiplatelet reactivity(LAPR)group.Platelet RNA was extracted from peripheral blood samples to measured miR-126 expression by using quantitative polymerase chain reaction(qPCR).SPSS statistics 27.0 was used for data analysis.Data comparison between two groups was performed using t test,Wilcoxon rank sum test or χ^(2) test depending on data type.Pearson correlation analysis was performed to analyze the correlation between platelet miR-126 and ticagrelor antiplatelet reactivity.Results The HAPR group had significantly higher ADP% than LAPR group[94.50%(92.95%,97.42%)vs 67.40%(57.00%,75.05%)],and elevated platelet expression level of miR-126[2.97(0.16,31.37)vs 1.00(0.17,3.31)]when compared with the LAPR group(P<0.001).Platelet miR-126 was positively correlated with ADP%after ticagrelor treatment(r=0.25;P=0.013).Conclusion Platelet miR-126 may affect ticagrelor antiplatelet reactivity in ACS patients.

关 键 词：急性冠脉综合征 血小板 微小核糖核酸-126 替格瑞洛 抗血小板反应性 

分 类 号：R541.4[医药卫生—心血管疾病]