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外周血单个核细胞miR-150表达对STEMI患者PCI术后发生左心室重构的预测价值
作者:高红霞  杨彩霞  任刚 
单位:铁岭市中心医院 心内科, 辽宁 铁岭 112000
关键词:ST段抬高型心肌梗死 经皮冠状动脉介入 左心室重构 miR-150 炎症 
分类号:R542.2
出版年·卷·期(页码):2021·40·第二期(170-175)
摘要:

目的:探讨外周血单个核细胞(PBMCs)中miR-150表达对ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后发生左心室重构(LVR)的预测价值。方法:选取2018年3月至2019年1月在我院接受急诊PCI术的STEMI患者165例,术后随访1年,复查超声心动图,左室舒张末期容积(LVEDV)比出院时增加≥20%则定义为LVR。根据超声心动图复查结果将患者分为LVR组和非LVR组。采用实时荧光定量PCR法测定PBMCs中miR-150表达,用双荧光素酶报告基因分析C反应蛋白(CRP)mRNA与miR-150的靶向结合关系。结果:35例患者发生LVR,LVR发生率为21.21%。LVR组患者PCI术后7 d PBMCs中miR-150相对表达量低于非LVR组(P<0.05)。多因素Logistic回归分析显示,PBMCs中miR-150表达是STEMI患者PCI术后发生LVR的独立预测因素(OR=0.230,95%CI 0.079~0.584,P<0.05)。经受试者工作特征(ROC)曲线分析,PCI术后7 d PBMCs中miR-150表达预测LVR的曲线下面积(AUC)为0.903(95%CI 0.858~0.948),大于单独使用左室射血分数(LVEF)的AUC(P<0.05)。双荧光素酶报告基因分析显示,miR-150类似物抑制了CRP-3'UTR-WT的荧光素酶活性(P<0.05)。结论:PCI术后7 d PBMCs中miR-150表达是STEMI患者1年内发生LVR的独立预测因子,这可能与诱导CRP表达上调有关。

Objective: To explore the predictive value of miR-150 in peripheral blood mononuclear cells (PBMCs) for left ventricular remodeling (LVR) after ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Methods: A total of 165 STEMI patients underwent emergency PCI in our hospital from March 2018 to January 2019 were followed up for 1 year. LVR was defined as an increase in left ventricular end-diastolic volume (LVEDV) of more than 20% over the baseline value according to the echocardiography. Patients were divided into LVR group and non-LVR group. The expression of miR-150 in PBMCs was determined by real-time fluorescent quantitative PCR, and the binding of C-reactive protein(CRP) mRNA to miR-150 was analyzed by double luciferase reporter gene. Results: The incidence of LVR was 21.21% (35/165) after 1 year follow up. The relative expression of miR-150 in PBMCs at 7 d after PCI was lower in LVR group than that in non-LVR group (P<0.05). The expression of miR-150 in PBMCs was an independent predictor of postoperative LVR in STEMI patients (OR=0.230, 95%CI 0.079-0.584, P<0.05). By receiver operating characteristic(ROC) curve analysis, the area under curve (AUC) of miR-150 expression in PBMCs at 7 d after PCI predicting LVR was 0.903 (95% CI 0.858-0.948), and higher than AUC of left ventricular ejection fraction (LVEF) alone (P<0.05). Luciferase reporter gene analysis showed that miR-150 mimics inhibited the luciferase activity of CRP-3'UTR-WT (P<0.05). Conclusion: The expression of miR-150 in PBMCs at 7 d after PCI is an independent predictor of the development of LVR in STEMI patients within 1 year, it may be related with up-regulating CRP expression.

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