摘要
目的探讨心肌缺血-再灌注患者血清中miR-21、miR-29a表达水平及其临床意义。方法回顾性分析本院2016年5月至2017年12月诊治的心肌缺血-再灌注患者80例临床资料,共分为急性ST段抬高性心肌梗死(STEMI)组、急性非ST段抬高性心肌梗死(非STEMI)组、不稳定型心绞痛(UAP)组、稳定型心绞痛(SAP)组,每组各20例,根据心肌缺血-再灌注预后情况将患者分为预后良好组和预后不良组;另选取同期体检的20例健康志愿者纳入对照组。采集所有受试者血清,用荧光实时定量PCR检测术前、术后1d、术后5d标本中miR-21、miR-29a表达水平,并进行比较分析。结果术前、术后1d、术后5d心肌缺血-再灌注患者血清中miR-21、miR-29a表达水平显著高于对照组(P均<0.05),且术前STEMI组(7.326±1.694,7.984±1.264)和非STEMI组(6.425±1.344,6.583±2.163)高于SAP组(3.324±1.695,3.365±1.635)和UAP组(4.265±0.885,4.324±1.035),组间比较差异有统计学意义(P均<0.05)。术后1d心肌缺血-再灌注患者miR-21、miR-29a表达水平升高,术后5d表达量下降,组间比较差异有统计学意义(P均<0.05)。对照组三个时间点差异无统计学意义(P>0.05)。预后良好组血清中miR-21、miR-29a均明显低于预后不良组(3.493±1.234vs.6.484±2.135,3.904±1.272vs.6.954±1.854,P均<0.05)。结论miR-21、miR-29a在心肌缺血-再灌注患者的血清中异常表达,联合检测有利于对心肌缺血-再灌注的发生、诊治和预后的评估。
Objective To investigate the expression and clinical significance of serum miR-21 and miR-29a in patients with myocardial ischemia and reperfusion.Methods We retrospectively analyzed 80 patients with myocardial ischemia-reperfusion in our hospital from May 2016 to December 2017.According to the prognosis of myocardial ischemia reperfusion,patients were divided into prognosis group and poor prognosis group.Twenty healthy volunteers who were examined were included in the control group.The serums of all subjects were collected.The expression levels of miR-21 and miR-29a in the serum were detected by real-time quantitative PCR before operation,1 day after operation and 5 days after operation.Results The expression levels of miR-21 and miR-29a in serum of patients with myocardial ischemia-reperfusion before and 1 day after operation were significantly higher than those of the control group(both P<0.05),and preoperative miR-21 and miR-29a the expression of 2 groups of myocardial infarction group(miR-21:7.326 ± 1.694,6.425 ± 1.344;miR-29a;7.984 ± 1.264,6.583 ± 2.163)>2 groups of angina pectoris group(miR-21:3.324 ± 1.695,4.265 ±0.885;miR-29a:3.365 ± 1.635,4.324 ± 1.035),the difference between the groups was statistically significant(P<0.05).The expression of miR-21 and miR-29a was decreased at 1 day after operation,and the expression of miR-21 and miR-29a was increased at 5 days after operation.The difference between the two groups was statistically significant(P<0.05).There was no significant difference in the three time points of the control group(P>0.05).The serum levels of miR-21 and miR-29a in the prognosis group were significantly lower than those in the poor prognosis group(3.493 ± 1.234 vs.6.484 ± 2.135,3.904 ± 1.272 vs.6.954 ± 1.854,P<0.05).Conclusion miR-21 and miR-29a are abnormally expressed in the serum of ptitients with myocardial ischemia and reperfusion.The combined detection of multiple miRNAs is conducive to the evaluation of the occurrence,diagnosis,treatment and prognosis of myocardial is
作者
张建兴
江志忠
Zhang Jian-xing;Jiang Zhi-zhong(Department of Cardiology,the Fifth Affiliated Hospital of Southern Medical University,Guangzhou 510900,China)
出处
《中国急救医学》
CAS
CSCD
北大核心
2019年第3期254-259,共6页
Chinese Journal of Critical Care Medicine
基金
广东省医学科学技术研究基金项目(A2017497).
