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外周血单个核细胞miR-143表达对STEMI患者急诊PCI术后1年发生支架内再狭窄的预测价值
作者:赵玉君1  孙宏超1  王翠平1  董自平2  路桂杰2 
单位:1. 任丘市人民医院 心内科, 河北 任丘 062552;
2. 华北石油总医院 急诊科, 河北 任丘 062552
关键词:外周血单个核细胞 miR-143 ST段抬高型心肌梗死 经皮冠状动脉介入术 支架内再狭窄 
分类号:R542.22
出版年·卷·期(页码):2021·40·第二期(164-169)
摘要:

目的:探讨外周血单个核细胞(PBMCs)miR-143表达对ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入术(PCI)后1年发生支架内再狭窄(ISR)的预测价值。方法:选取2019年3月至10月在任丘市人民医院诊断为STEMI并行急诊PCI的患者72例,33例患者在术后1年内发生ISR,纳入ISR组;39例未发生ISR的患者纳入非ISR组。患者均有详细和可追溯的医疗记录。采用实时荧光定量聚合酶链反应(RT-qPCR)检测患者PCI术后3 h PBMCs中miR-143表达,并检测血清B淋巴细胞瘤-2(Bcl-2)、白细胞介素(IL-6)水平。结果:与非ISR组相比,ISR组患者PBMCs中miR-143相对表达量降低,同时血清Bcl-2和IL-6水平升高(P<0.05)。经多因素Logistic回归分析,PBMCs中miR-143表达与ISR的发生风险有关(OR=6.367,95%CI 2.434~13.679,P<0.05)。经受试者工作特性(ROC)曲线分析,PCI术后PBMCs中miR-143表达预测STEMI患者急诊PCI术后1年发生支架内再狭窄的曲线下面积(AUC)为0.954(95%CI 0.910~0.998),cut-off值为0.795,在该阈值下灵敏度和特异度分别为94.9%和81.8%。经Pearson相关分析,ISR组患者PBMCs中miR-143相对表达量与血清Bcl-2、IL-6水平呈负相关性(r=-0.739、-0.646,均P<0.05)。结论:STEMI患者PBMCs中miR-143低表达是增加PCI术后1年发生ISR风险的独立危险因素,其表达水平降低与血清Bcl-2和IL-6含量增加有关。

Objective: To investigate the predictive value of miR-143 expression in peripheral blood mononuclear cells (PBMCs) for in-stent restenosis(ISR) in ST-segment elevation myocardial infarction (STEMI) patients one year after emergency percutaneous coronary intervention (PCI). Methods: From March 2019 to October 2019, 72 patients diagnosed with STEMI undergone emergency PCI, and with detailed and traceable medical records were enrolled into this study and divided into ISR group (n=33) and non-ISR group (n=39). Quantitative polymerase chain reaction (RT-qPCR) was used to determine the content of miR-143 in PBMCs, and the levels of serum B-cell lymphoma-2 (Bcl-2) and interleukin 6 (IL-6) were detected by ELISA. Results: Compared with non-ISR group, the relative expression of miR-143 in PBMCs decreased in non-ISR group, while the levels of Bcl-2 and IL-6 increased (P<0.05). The expression of miR-143 in PBMCs was associated with the occurrence risk of ISR (OR=6.367, 95% CI 2.434-13.679,P<0.05). AUC of the expression of miR-143 in PBMCs for predicting ISR in STEMI patients one year after emergency PCI was 0.954 (95%CI 0.910-0.998),the cut-off was 0.795, whose sensitivity and specificity were 94.9% and 81.8%, respectively. Pearson correlation showed that the relative expression of miR-143 in PBMCs of ISR group was negatively correlated with the levels of Bcl-2 and IL-6(r=-0.739, -0.646, P<0.05). Conclusion: Low expression of miR-143 in STEMI patients is an independent risk factor for increased ISR risk one year after PCI, which is associated with the increased expressions of Bcl-2 and IL-6.

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