摘要
目的探讨冠心病患者外周血微小核糖核酸-126(miRNA-126)、血小板与γ-谷氨酰转移酶比值(PLT/GGT)、游离三碘甲状腺原氨酸(FT3)水平与血管内皮功能及斑块稳定性之间的关系。方法前瞻性选取2023年2月至2024年2月于上海交通大学医学院附属瑞金医院心内科收治的120例冠心病患者作为研究对象,根据斑块稳定性进行分组:稳定斑块组(n=51)和不稳定斑块组(n=69)。比较两组患者的临床资料。比较两组患者的外周血miRNA-126、PLT/GGT、FT3、内皮细胞特异性分子-1(ESM-1)、一氧化氮(NO)、内皮素-1水平。采用Pearson相关分析miRNA-126、PLT/GGT及FT3水平与血管内皮功能指标ESM-1、内皮素-1、一氧化氮的相关性。采用Logistic回归分析探究miRNA-126、PLT/GGT及FT3水平与斑块稳定性的关系。结果不稳定斑块组患者的纤维帽厚度低于稳定斑块组,脂质核心比例高于稳定斑块组,差异均有统计学意义(P<0.05)。不稳定斑块组患者的miRNA-126相对表达量、PLT、PLT/GGT、FT3分别为0.48±0.12、(180.22±10.64)×10^(9)/L、2.46±0.38、(4.33±0.58)pmol/L,均低于稳定斑块组[0.61±0.21、(188.21±11.03)×10^(9)/L、2.81±0.39、(4.67±0.64)pmol/L],不稳定斑块组GGT为(73.15±8.44)U/L,高于稳定斑块组[(66.98±7.15)U/L],差异均有统计学意义(P<0.05)。不稳定斑块组ESM-1、内皮素-1水平分别为(3.08±0.58)ng/mL、(12.36±2.39)pg/mL,均高于稳定斑块组[(1.78±0.31)ng/mL、(8.33±1.23)pg/mL],而不稳定斑块组NO水平为(20.23±4.11)μmol/L,低于稳定斑块组[(25.21±5.33)μmol/L],差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,miRNA-126、PLT、PLT/GGT、FT3水平与ESM-1、内皮素-1水平均呈负相关(P<0.05),与一氧化氮水平呈正相关(P<0.05);GGT水平与ESM-1、内皮素-1水平均呈正相关(P<0.05),与一氧化氮水平呈负相关(P<0.05)。Logistic回归分析结果显示,miRNA-126、PLT/GGT及FT3水平均为冠心病患者斑块稳定性的影响因素(P<0.05)。结论冠心病患者外周血miRNA-126、PLT/GGT和FT3水平与血管内皮功能密切相关,且在伴有不稳定斑块的冠心病患者外周血中miRNA-126、PLT/GGT和FT3水平显著降低。
Objective To investigate the association of circulating microRNA-126(miRNA-126),the platelet-to-γ-glutamyl transferase ratio(PLT/GGT),and free triiodothyronine(FT3)with endothelial function and plaque stability in patients with coronary heart disease.Methods A total of 120 coronary heart disease patients admitted to the Department of Cardiology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2023 to February 2024 were prospectively enrolled.Based on plaque characteristics,they were categorized into the stable plaque group(n=51)and the unstable plaque group(n=69).The clinical data of the two groups were compared.The levels of miRNA-126,PLT/GGT,FT3,endothelial cell specific molecule-1(ESM-1),nitric oxide(NO)and endothelin-1 in peripheral blood were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between miRNA-126,PLT/GGT and FT3 levels and vascular endothelial function indexes ESM-1,endothelin-1 and nitric oxide.Logistic regression analysis was used to explore the relationship between miRNA-126,PLT/GGT and FT3 levels and plaque stability.Results The fiber cap thickness of the unstable plaque group was lower than that of the stable plaque group,and the proportion of lipid core was higher than that of the stable plaque group,the differences were statistically significant(P<0.05).The relative expression of miRNA-126,PLT,PLT/GGT,and FT3 in the unstable plaque group were 0.48±0.12,(180.22±10.64)×10^(9)/L,2.46±0.38,and(4.33±0.58)pmol/L,respectively,which were lower than those in the stable plaque group[0.61±0.21,(188.21±11.03)×10^(9)/L,2.81±0.39,(4.67±0.64)pmol/L],and GGT in the unstable plaque group was(73.15±8.44)U/L,which was higher than that in the stable plaque group[(66.98±7.15)U/L],and the difference was statistically significant(P<0.05).The levels of ESM-1 and endothelin-1 in the unstable plaque group were(3.08±0.58)ng/mL and(12.36±2.39)pg/mL,respectively,which were higher than those in the stable group[(1.78±0.31)ng/mL,(8.33±1.23)pg/mL],while the level of NO in the unstable plaque group was(20.23±4.11)μmol/L,which was lower than that in the stable group[(25.21±5.33)μmol/L],the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the levels of miRNA-126,PLT,PLT/GGT and FT3 were negatively correlated with the levels of ESM-1 and endothelin-1(P<0.05),and positively correlated with the level of nitric oxide(P<0.05).The level of GGT was positively correlated with the levels of ESM-1 and endothelin-1(P<0.05),and negatively correlated with the level of nitric oxide(P<0.05).Logistic regression analysis showed that miRNA-126,PLT/GGT and FT3 levels were the influencing factors of plaque stability in patients with coronary heart disease(P<0.05).Conclusion Circulating miRNA-126,PLT/GGT,and FT3 are closely related to endothelial function in coronary heart disease patients,and their levels are markedly decreased in those with unstable plaques,suggesting potential value in evaluating plaque stability.
作者
陶晴岚
汤静
陆臻
TAO Qinglan;TANG Jing;LU Zhen(Department of Cardiology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China)
出处
《临床和实验医学杂志》
2025年第21期2245-2249,共5页
Journal of Clinical and Experimental Medicine
基金
上海市卫生健康委员会科研课题支持项目(编号:202040038)。
