miRNA-106b-5p表达水平与急性ST段抬高型心肌梗死患者心室重构的关系

刘泽岩; 刘励军

doi:10.12125/j.chj.202004100

miRNA-106b-5p表达水平与急性ST段抬高型心肌梗死患者心室重构的关系

The diagnostic value of miR-106b-5p in acute ST segment elevation myocardial infarction and its relationship with ventricular remodeling

摘要

摘要:
目的分析急性ST段抬高型心肌梗死（ST segment elevation myocardial infarction, STEMI）患者外周血微小核糖核酸-106b-5p（microRNA-106b-5p, miR-106b-5p）水平与梗死后出现心室重构（ventricular remodeling, VR）和发生主要心脏不良事件(major adverse cardiac events, MACE)的相关性。
方法选取2018年1月~2020年2月我院就诊的STEMI患者90例作为STEMI组，同期临床及冠脉造影证实为稳定型冠心病（stable coronary heart disease, SCAD）90例作为对照组。使用荧光实时定量法（real-time quantitative reverse transcription polymerase chain reaction, qRT-PCR）检测两组入院时外周血miR-106b-5p水平，根据STEMI组术后及出院6个月的心脏彩超结果，判断STEMI组VR的情况。以STEMI最佳诊断阈值为分界，分析STEMI组不同miR-106b-5p水平与VR的关系。采用Kaplan-Meier生存曲线分析STEMI组不同miR-106b-5p水平患者出院后12个月的MACE发生情况。
结果低表达组较高表达组CK.CK-MB和CTnI显著增大（P<0.01），CK、CK-MB和CTnI与miRNA-0.6-5P呈负相关关系（均P<0.05）。高表达组（miR-106b-5p≥0.41，58例）出院后6个月出现VR 1例（2%），显著低于低表达组（miR-106b-5p<0.41，32例）5例（16%）, （P<0.05）；高表达组随访12月2例（3%）发生MACE（心肌梗死1例和卒中1例），显著低于低表达组5例（16%）（心肌梗死3例和卒中2例）（Log-rank χ²=4.725，P<0.05）。出院后6个月外周血miRNA-106-5p水平与左室舒张末内径（LVEDd）呈负相关（r=−0.437, P<0.05），与左室射血分数（LVEF）呈正相关（r=0.414, P<0.05）。
结论外周血miR-106b-5p水平与心梗后VR及MACE存在相关性。

Abstract:
AIM To analyze the correlation of the peripheral blood microRNA-106b-5p(miR-106b-5p) in patients with acute ST segment elevation myocardial infarction (STEMI) with ventricular remodeling (VR) and major adverse cardiac events (MACE) after infarction.
METHODS 90 STEMI patients from January 2018 to February 2020 were selected as the STEMI group, as the same time, 90 cases of stable coronary heart disease (SCAD) were confirmed by clinical and coronary angiography as the SCAD group. The real-time quantitative reverse transcription polymerase chain reaction (qrt-PCR) was used to detect the peripheral blood mir-106b-5p in 2 groups as the admission, 2 days after treatment and 6 months after discharge. According to the results of color doppler echocardiography of the STEMI group after surgery and 6 months after discharge, the VR of the STEMI group was judged.Take STEMI diagnostic threshold as the boundary, to analyze the relationship between mir-106b-5p and VR in the STEMI group.Kaplan-Meier survival curve was used to analyze the major adverse cardiac events (MACE) of patients with different miR-106b-5p levels in STEMI group at 12 months after discharge.
RESULTS In the high expression subgroup (miR-106b-5p ≥ 0.41, 58 patients), VR occurred in 1 case (1.72%) 6 months after discharge, which was significantly lower than that in the low expression subgroup (miR-106b-5p <0.41, 32 cases)(15.60%). (χ²=4.564, P<0.05). MACE (1 case myocardial infarction and 1 case stroke) occurred in 2 cases (3.45%) of the high expression subgroup during 12 months’ follow-up, which was lower than 5 cases (15.63%) of the low expression group (3 cases myocardial infarction and 2 cases stroke) (Log-rank χ²=4.725, P<0.05). The level of miRNA-106-5p in peripheral blood was negatively correlated with LVEDd at 6 months after discharge (r =−0.437, P<0.05), positively correlated with LVEF (r = 0.414, P<0.05).
CONCLUSION There is a correlation between miR-106b-5p in peripheral blood and VR and MACE after myocardial infarction.

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