摘要
目的分析冠心病患者外周血微小核糖核酸-10a(miR-10a)、miR-342-5p表达与炎性因子的关系及其对冠心病的预测价值。方法选取2016年8月—2019年2月广东省茂名市中医院心血管病科诊治的冠心病患者153例为观察组,根据临床分型分为急性心肌梗死(AMI亚组)61例、不稳定型心绞痛(UAP亚组)49例、稳定型心绞痛(SAP亚组)43例;根据纽约心脏病学会心功能分级(NYHA)分为心功能Ⅱ级78例、心功能Ⅲ级41例、心功能Ⅳ级34例。并随机选取同期健康体检者100例作为健康对照组。检测受试者血浆miR-10a、miR-342-5p表达水平及血清白介素-6(IL-6)、IL-8、IL-10、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平。分析血浆miR-10a、miR-342-5p表达水平与血清炎性因子的相关性,采用受试者工作特征曲线(ROC)评估其对冠心病的预测价值。结果不同类型、不同心功能分级冠心病患者血浆miR-10a表达水平低于健康对照组,miR-342-5p表达水平高于健康对照组,且随着病情不断加重,冠心病患者血浆miR-10a表达水平逐渐降低,miR-342-5p表达水平逐渐升高(F/P=221.186/0.000、121.489/0.000,207.724/0.000、72.694/0.000)。不同类型、不同心功能分级冠心病患者血清IL-6、IL-8、hs-CRP、TNF-α水平高于健康对照组,IL-10水平低于健康对照组,且随着病情不断加重,冠心病患者血清IL-6、IL-8、hs-CRP、TNF-α水平逐渐升高,IL-10水平逐渐降低(F/P=46.548/0.000、82.908/0.000、95.354/0.000、94.008/0.000、17.253/0.000,45.243/0.000、63.033/0.000、86.294/0.000、69.631/0.000、16.099/0.000)。经Pearson相关分析,冠心病患者血浆miR-10a表达水平与血清IL-6、IL-8、hs-CRP、TNF-α呈负相关(r/P=-0.581/0.006、-0.612/0.002、-0.706/0.001、-0.645/0.003),与IL-10呈正相关(r/P=0.639/0.001);血浆miR-342-5p表达水平与血清IL-6、IL-8、hs-CRP、TNF-α呈正相关(r/P=0.630/0.003、0.623/0.001、0.681/0.001、0.607/0.005),与IL-10呈负相关(r/P=-0.672/0.001)。miR-10a、miR-342-5p对冠心病均具有较好的预测价值,联合检测预测价值最高,AUC为0.952(95%CI 0.915~0.989),敏感度、特异度、准确度分别为0.86、0.85、0.87,约登指数为0.71。结论冠心病患者血浆miR-10a表达水平降低,miR-342-5p表达水平升高,两者通过调控炎性因子水平参与炎性反应,进而参与冠心病发病,早期联合检测可作为临床辅助预测冠心病的潜在标志物。
Objective To analyze the relationship between the expression of peripheral blood microribonucleic acid 10a(miR-10a)and miR-342-5p and inflammatory factors in patients with coronary heart disease,and its predictive value for coronary heart disease.Methods Selected 153 patients with coronary heart disease diagnosed and treated in the Department of Cardiovascular Diseases,Maoming City Hospital of Traditional Chinese Medicine,Guangdong Province from August 2016 to February 2019 as the observation group.According to the clinical classification,they were divided into 61 cases of acute myocardial infarction(AMI subgroup),unstable There were 49 cases of type angina(UAP subgroup)and 43 cases of stable angina(SAP subgroup).According to the New York Society of Cardiology Cardiac Function Classification(NYHA),78 cases were classified into 78 cases of cardiac function II,41 cases of cardiac function III,and 34 cases of cardiac function IV.And 100 cases of healthy physical examination during the same period were randomly selected as healthy control group.The expression levels of plasma miR-10a and miR-342-5p and the levels of serum interleukin 6(IL-6),IL-8,IL-10,high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)were detected.Analyze the correlation between the expression levels of plasma miR-10a and miR-342-5p and serum inflammatory factors,and use receiver operating characteristic curve(ROC)to evaluate their predictive value for coronary heart disease.Results The expression level of plasma miR-10a in patients with different types and different levels of cardiac function is lower than that of healthy controls,and the expression level of miR-342-5p is higher than that of healthy controls.As the disease continues to worsen,the expression of plasma miR-10a in patients with coronary heart disease gradually decreases.The expression level of miR-342-5p gradually increased(F/P=221.186/0.000,121.489/0.000,207.724/0.000,72.694/0.000).The levels of serum IL-6,IL-8,hs-CRP,and TNF-αin patients with different types and different levels of cardiac function were higher than those in healthy controls,and IL-10 levels were lower than those in healthy controls.As the disease continued to worsen,serum IL in patients with coronary heart disease 6.The levels of IL-8,hs-CRP and TNF-αgradually increased,and the levels of IL-10 gradually decreased(F/P=46.548/0.000,82.908/0.000,95.354/0.000,94.008/0.000,17.253/0.000,45.243/0.000,63.033/0.000,86.294/0.000,69.631/0.000,16.099/0.000).According to Pearson correlation analysis,the expression level of plasma miR-10a in patients with coronary heart disease is negatively correlated with serum IL-6,IL-8,hs-CRP,and TNF-α(r/P=-0.581/0.006,-0.612/0.002,-0.706/0.001,-0.645/0.003),positively correlated with IL-10(r/P=0.639/0.001).The expression level of plasma miR-342-5p was positively correlated with serum IL-6,IL-8,hs-CRP,and TNF-α(r/P=0.630/0.003,0.623/0.001,0.681/0.001,0.607/0.005),and negatively correlated with IL-10(r/P=-0.672/0.001).miR-10a and miR-342-5p have good predictive value for coronary heart disease,and the combined detection has the highest predictive value,with an AUC of 0.952(95%CI 0.915~0.989),sensitivity,specificity,and accuracy of 0.86,0.85,and 0.87,respectively,Yoden Index is 0.71.Conclusion The expression level of plasma miR-10a in patients with coronary heart disease decreases,and the expression level of miR-342-5p increases.Both of them participate in the inflammatory response by regulating the level of inflammatory factors,and then participate in the pathogenesis of coronary heart disease.Early combined detection can be used as a potential marker for clinical assistance in predicting coronary heart disease.
作者
方填源
陈哲林
劳彩光
董德怀
余英滔
Fang Tianyuan;Chen Zhelin;Lao Caiguang;Dong Dehuai;Yu Yingtao(Department of Cardiovascular, Maoming Hospital of Traditional Chinese Medicine of Guangdong Province, Guangdong Province, Maoming 525000,China)
出处
《疑难病杂志》
CAS
2021年第1期31-36,共6页
Chinese Journal of Difficult and Complicated Cases
基金
广东省医学科研基金立项项目(A20183272)。
