目的：通过检测微小RNA-324-5p（miR-324-5p）在动脉粥样硬化（AS）患者血清中的表达水平，分析miR-324-5p在临床中的诊断和预后评估价值。方法：通过实时荧光定量PCR技术检测AS患者与健康对照人群血清中miR-324-5p的表达水平；采用Spearman相关系数分析miR-324-5p的表达与颈动脉内膜-中膜厚度（CIMT）的相关性；通过受试者工作特征曲线（ROC曲线）评估miR-324-5p在AS中的诊断价值；通过Kaplan-Meier生存曲线、单因素和多因素Cox回归分析检测miR-324-5p在AS中的预后评估价值。结果：AS患者血清中miR-324-5p的表达水平较健康对照人群显著下降（P<0.001），且miR-324-5p在CIMT值较低的患者中表达，两者为负相关性（r=-0.8043，P<0.001）。ROC曲线下面积为0.874，具有较高的敏感性（80%）和特异性（87.1%），证明miR-324-5p在AS患者中具有较高的诊断准确性。同时发现miR-324-5p可以作为AS的独立预后因子（HR=3.318，95% CI=1.219~9.031，P=0.019），低表达miR-324-5p患者发生心血管事件的概率较高（log-rank P=0.002）。结论：低表达miR-324-5p可以作为AS诊断的一种潜在标志物，并且与AS的不良预后相关。

[1] FEINBERG M W,MOORE K J.MicroRNA regulation of atherosclerosis[J].Circ Res,2016,118(4):703-720.
[2] QUILLARD T,LIBBY P.Molecular imaging of atherosclerosis for improving diagnostic and therapeutic development[J].Circ Res,2012,111(2):231-244.
[3] DI GREGOLI K,MOHAMAD ANUAR N N,BIANCO R,et al.MicroRNA-181b controls atherosclerosis and aneurysms through regulation of TIMP-3 and elastin[J].Circ Res,2017,120(1):49-65.
[4] HARTMANN P,ZHOU Z,NATARELLI L,et al.Corrigendum:endothelial dicer promotes atherosclerosis and vascular inflammation by miRNA-103-mediated suppression of KLF4[J].Nat Commun,2016,7:11907.
[5] CHISTIAKOV D A,OREKHOV A N,BOBRYSHEV Y V.The role of miR-126 in embryonic angiogenesis,adult vascular ho- meostasis,and vascular repair and its alterations in atherosclerotic disease[J].J Mol Cell Cardiol,2016,97:47-55.
[6] WANG K,ZHANG D L,LONG B,et al.NFAT4-dependent miR-324-5p regulates mitochondrial morphology and cardiomyocyte cell death by targeting Mtfr1[J].Cell Death Dis,2015,6:e2007.
[7] DIAZ I,CALDERON-SANCHEZ E,TORO R D,et al.miR-125a,miR-139 and miR-324 contribute to urocortin protection against myocardial ischemia-reperfusion injury[J].Sci Rep,2017,7(1):8898.
[8] ELLIS K L,CAMERON V A,TROUGHTON R W,et al.Circulating microRNAs as candidate markers to distinguish heart failure in breathless patients[J].Eur J Heart Fail,2013,15(10):1138-1147.
[9] CAO L,XIE B,YANG X,et al.MiR-324-5p suppresses hepatocellular carcinoma cell invasion by counteracting ECM degradation through post-transcriptionally downregulating ETS1 and SP1[J].PLoS One,2015,10(7):e0133074.
[10] FERRETTI E,DE SMAELE E,MIELE E,et al.Concerted microRNA control of Hedgehog signalling in cerebellar neuronal progenitor and tumour cells[J].EMBO J,2008,27(19):2616-2627.
[11] MATKOVICH S J,VAN BOOVEN D J,YOUKER K A,et al.Reciprocal regulation of myocardial microRNAs and messenger RNA in human cardiomyopathy and reversal of the microRNA signature by biomechanical support[J].Circulation,2009,119(9):1263-1271.
[12] XIAO J,LIANG D,ZHANG Y,et al.MicroRNA expression signature in atrial fibrillation with mitral stenosis[J].Physiol Genomics,2011,43(11):655-664.
[13] IKEDA S,KONG S W,LU J,et al.Altered microRNA expression in human heart disease[J].Physiol Genomics,2007,31(3):367-373.
[14] THUM T,GALUPPO P,WOLF C,et al.MicroRNAs in the human heart:a clue to fetal gene reprogramming in heart failure[J].Circulation,2007,116(3):258-267.
[15] VOELLENKLE C,VAN ROOIJ J,CAPPUZZELLO C,et al.MicroRNA signatures in peripheral blood mononuclear cells of chronic heart failure patients[J].Physiol Genomics,2010,42(3):420-426.