摘要
目的探讨microRNA-21(miR-21)在预测冠心病慢性闭塞病变(CTO)患者侧支循环是否良好中的作用。方法选取95例冠脉造影提示CTO的冠心病患者,根据患者冠脉侧支循环情况将其分为侧支循环良好组(53例)及侧支循环不良组(42例),选择冠脉造影正常的30例患者作为对照组,采用实时荧光定量PCR法检测miR-21水平,ELISA法检测缺氧诱导因子-1α(HIF-1α)水平。Logistic回归分析法分析冠脉侧支循环形成的影响因素,应用接受者操作特征曲线(ROC曲线)评价miR-21对CTO病变患者冠脉侧支循环是否良好的预测效能。结果与冠脉侧支循环不良组相比,冠脉侧支循环良好组血浆miR-21及HIF-1α水平明显升高(P<0.05);CTO病变组较正常冠脉组miR-21及HIF-1α水平明显降低(P<0.05);miR-21水平与HIF-1α表达呈正相关(r=0.804,P<0.05);miR-21(OR=4.762,95%CI为2.395~6.164,P<0.05)及HIF-1α(OR=12.906,95%CI为11.774~15.048,P<0.05)水平均为CTO冠脉侧支循环形成良好的预测因子;miR-21可有效区分CTO病变侧支循环是否良好(AUC为0.93,P<0.05)。结论循环miR-21水平在CTO侧支循环良好组明显升高,可作为区分冠心病CTO病变患者侧支循环是否良好的生物标志物。
Objective To investigate the role of microRNA-21 （miR-21） in predicting the collateral circulation in patients with coronary chronic total occlusions （CTO）. Methods Ninety-five patients with coronary heart disease who were prompted by coronary angiography for CTO were divided into the well group （53 cases） and the poorly group （42 cases） according to the coronary collateral circulation,another 30 patients with normal coronary angiography were selected as the control group.The level of miR-21 was determined by real-time quantitative reverse transcription polymerase chain reaction,hypoxia-inducible factor-1α （HIF-1α） was detected by ELISA.Logistic regression analysis was used to analyze the influencing factors of the coronary collateral circulation formation.The receiver operating characteristic curve （ROC curve） was applied to evaluate the predictive efficacy of miR-21 on the coronary collateral circulation in patients with CTO. Results The levels of miR-21 and HIF-1α significantly increased in the well group compared with the poorly group （ P 〈 0.05）;the levels of miR-21 and HIF-1α significantly decreased in the CTO group compared with the control group （ P 〈0.05）;the level of miR-21 was positively correlated to the HIF-1α expression （ r = 0.804 , P 〈 0.05 ）.Both miR-21 （ OR =4.762,95% CI 2.395-6.164, P 〈0.05） and HIF-1α （ OR = 12.906 ,95% CI 11.774- 15.048, P 〈0.05） were the predictors indicating well developed coronary collateral circulation formation in the CTO patients; miR-21 could effectively distinguish whether the coronary collateral circulation formation was good or not （AUC was 0.93, P 〈0.05）. Conclusion The level of circulating miR-21 significantly increases in the well group,and it can be used as a biomarkers to distinguish whether the collateral circulation of patients with coronary heart disease CTO lesions is good or not.
作者
廖清池
胡艳丽
周胜华
LIAO Qingchi;HU Yanli;ZHOU Shenghua(Department of Cardiology,Northern Jiangsu People′s Hospital Affiliated to YangzhouUniversity,Yangzhou,Jiangsu 225001,China;Department of Cardiology,the Second Xiangya HospitalAffiliated to Central South University,Changsha,Hunan 410000,China)
出处
《重庆医学》
CAS
2018年第23期3043-3046,共4页
Chongqing medicine
基金
扬州市自然科学基金资助项目(YZ2014045)
