血清miR-145和miR-146a水平对急性冠脉综合征PCI术后慢血流/无复流的预测价值

Predictive value of serum miR-145 and miR-146a for slow flow/no reflow coronary artery after PCI in patients with acute coronary syndrome

摘要:

目的]探讨血清微小RNA145(miR-145)和miR-146a对急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后冠状动脉慢血流/无复流(CSF/NRF)的预测价值。 [方法]选取2020年1月—2024年1月武汉市蔡甸区人民医院收治的ACS患者323例,根据PCI术后是否发生CSF/NRF分为正常血流组(n＝262)和CSF/NRF组(n＝61),采用RT-qPCR检测血清miR-145和miR-146a相对表达量,收集分析一般临床资料,Logistic回归分析患者发生CSF/NRF的影响因素,受试者工作特征(ROC)曲线分析血清miR-145、miR-146a对患者发生CSF/NRF的预测价值。 [结果]与正常血流组相比,CSF/NRF组血清miR-145相对表达量显著降低,C反应蛋白(CRP)和脑钠肽(BNP)水平及miR-146a相对表达量显著升高(均P＜0.05)；血清miR-146a、CRP和BNP水平升高为患者发生CSF/NRF的危险因素(P＜0.05),血清miR-145水平升高为患者发生CSF/NRF的拮抗因素(P＜0.05)；血清miR-145和miR-146a水平以及二者联合预测患者术后发生CSF/NRF的曲线下面积(AUC)分别为0.853、0.811和0.920,联合预测显著优于miR-145(Z＝2.919,P＝0.004)、miR-146a(Z＝3.341,P＝0.001)水平单独预测。 [结论]ACS患者血清miR-145和miR-146a对PCI术后CSF/NRF发生具有一定辅助预测价值。

Abstract:

Aim To explore the predictive value of serum microRNA-145 (miR-145) and miR-146a for postoperative coronary slow flow/no reflow (CSF/NRF) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods From January 2020 to January 4,3 patients with ACS who admitted to Caidian District People's Hospital were gathered. They were divided into normal blood flow group (n＝262) and CSF/NRF group (n＝61) based on whether they experienced CSF/NRF after PCI. Relative expression of serum miR-145 and miR-146a was detected by RT-qPCR. General clinical data were collected and analyzed. Logistic regression analysis was applied to analyze the influencing factors of CSF/NRF in patients after PCI. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of serum miR-145 and miR-146a for the occurrence of CSF/NRF in patients after PCI. Results Compared with the normal blood flow group, the relative expression level of serum miR-145 was greatly reduced in the CSF/NRF group, while patients in the CSF/NRF group had significantly higher levels of C-reactive protein (CRP) and brain natriuretic peptide (BNP), and the relative expression level of miR-146a (P＜0.05). Increased levels of CRP, BNP and relative expression of miR-146a were risk factors for CSF/NRF in patients (P＜0.05), while increased relative expression of miR-145 was a protective factor for CSF/NRF in patients (P＜0.05). The area under the curve (AUC) of serum levels of miR-145, miR-146a, and their combination for predicting postoperative CSF/NRF in patients was 0.3,0.811, and 0.920, respectively. The combined prediction was greatly better than miR-145 (Z＝2.919, P＝0.004) and miR-146a (Z＝3.341, P＝0.001) alone prediction. Conclusion Serum miR-145, miR-146a in patients with ACS has an adjunctive predictive value for CSF/NRF occurrence after PCI.