外周血内皮微粒中miR-126水平与MHR在急性心肌梗死患者PCI术后的表达水平及临床意义

帕丽达·玉山江; 艾买提江·买买提; 古力斯坦·艾斯卡尔; 尼格热·阿力木; 吐尔孙阿依·依斯提米拉; 穆叶赛·尼加提

doi:10.13201/j.issn.1001-1439.2024.09.008

外周血内皮微粒中miR-126水平与MHR在急性心肌梗死患者PCI术后的表达水平及临床意义

- 1.
  新疆维吾尔自治区第二人民医院急救中心(乌鲁木齐，830000)
- 2.
  喀什地区第二人民医院心内科
- 3.
  新疆医科大学
- 4.
  新疆维吾尔自治区人民医院急救中心
基金项目:
新疆维吾尔自治区自然科学基金计划特配项目(No：2023D03017)

详细信息

通讯作者: 穆叶赛·尼加提，E-mail：muyassar@aliyun.com

中图分类号: R541.4

收稿日期: 2024-04-08

刊出日期: 2024-09-13

Expression levels and clinical significance of miR-126 in circulating endothelial microparticles and the monocyte to high-density lipoprotein ratio in patients with acute myocardial infarction after percutaneous coronary intervention

- 1.
  Emergency Center, The Second People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830000, China
- 2.
  Department of Cardiology, The Second People's Hospital of Kashgar
- 3.
  Xinjiang Medical University
- 4.
  Emergency Center, Xinjiang Uygur Autonomous Region People's Hospital

More Information

Corresponding author: Muyesai Nijiati, E-mail: muyassar@aliyun.com

Received Date: 08 April 2024

Publish Date: 13 September 2024

摘要

摘要: 目的分析急性心肌梗死(AMI)患者在接受经皮冠状动脉介入治疗(PCI)后，外周血内皮细胞来源的微粒中的microRNA-126(miR-126)表达水平以及单核细胞与高密度脂蛋白胆固醇比值(MHR)的变化及其临床意义。方法纳入2019—2022年在新疆维吾尔自治区人民医院心内科进行冠状动脉造影(CAG)，随后确诊为AMI并接受PCI治疗的60例患者(AMI组)。同时，纳入60例慢性冠状动脉疾病(CCD)患者(CCD组)以及60例健康个体(健康组)作为对照。测定并对比各组患者外周血内皮微粒中的miR-126和MHR表达水平，并计算Gensini评分。相关性分析采用Spearman检验，AMI发生的危险因素采用logistic回归分析，各指标的诊断价值采用ROC曲线分析。结果 AMI组miR-126水平低于CCD组及对照组，MHR高于CCD组及对照组。Spearman相关性分析结果表明，miR-126的表达水平与Gensini评分呈负相关性(r=-0.460，P < 0.001)，MHR与Gensini评分呈正相关性(r=0.468，P < 0.001)。多因素logistic回归分析显示，miR-126(OR=6.995，95%CI：2.126~23.018，P=0.001)、MHR(OR=4.527，95%CI：1.145~17.895，P < 0.031)和Gensini评分(OR=0.949，95%CI：0.925~0.974，P < 0.001)是AMI发生的独立危险因素。ROC曲线分析表明，miR-126、MHR和Gensini评分联合检测预测AMI的曲线下面积(AUC)为0.894(95%CI：0.951~0.836，P < 0.001)，特异度为95%，灵敏度为76.7%，高于各指标单独预测。结论 miR-126水平和MHR与AMI的发生及冠心病严重程度有重要联系，是潜在的预测和诊断AMI的生物标记物。
- 急性心肌梗死 /
- 经皮冠状动脉介入 /
- microRNA-126 /
- 单核细胞/高密度脂蛋白胆固醇比值
Abstract: Objective To analyze the expression levels of microRNA-126(miR-126) in endothelial cell-derived microparticles in peripheral blood and the changes in the ratio of monocyte to high-density lipoprotein cholesterol(MHR) in patients with acute myocardial infarction(AMI) after undergoing percutaneous coronary intervention(PCI), as well as their clinical significance.Methods Sixty patients who underwent coronary angiography(CAG) and were subsequently diagnosed with AMI, then received PCI treatment at the Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region from 2019 to 2022 were included(AMI group). Additionally, 60 patients with chronic coronary disease(CCD) were included in the CCD group, 60 healthy individuals were included in the health group. The expression levels of miR-126 in peripheral blood endothelial microparticles, the MHR, and Gensini scores among each group were measured and compared. The correlation analysis was conducted using Spearman test, the risk factors for AMI were analyzed using logistic regression, and the diagnostic value of each indicator was analyzed using ROC curve.Results The miR-126 levels in the AMI group were lower than those in the CCD and control groups, while the MHR was higher than those in the CCD and NC groups. The Spearman correlation analysis indicated that the miR-126 levels was negatively correlated with Gensini scores(r=-0.460, P < 0.001), while MHR was positively correlated with Gensini score(r=0.468, P < 0.001). Multivariate logistic regression analysis showed that miR-126(OR=6.995, 95%CI: 2.126-23.018, P=0.001), MHR(OR=4.527, 95%CI: 1.145-17.895, P < 0.031), and Gensini score(OR=0.949, 95%CI: 0.925-0.974, P < 0.001) were independent risk factors for the occurrence of AMI. ROC curve analysis indicated that the area under the curve(AUC) of miR-126, MHR, and Gensini score combined detection for predicting AMI was 0.894(95%CI: 0.951-0.836, P < 0.001), with a specificity of 95% and a sensitivity of 76.7%, which was higher than the prediction of each indicator separately.Conclusion The levels of miR-126 and MHR are significantly associated with the occurrence and severity of coronary heart disease, and they are potential biomarkers for diagnosing and predicting AMI.
- acute myocardial infarction /
- percutaneous coronary intervention /
- microRNA-126 /
- monocyte to high-density lipoprotein cholesterol ratio

HTML全文

图 1 miR-126、MHR及Gensini评分预测AMI的ROC曲线

Figure 1. ROC curves for predicting AMI using miR-126, MHR, and Gensini score

下载: 全尺寸图片幻灯片

表 1 患者一般临床资料比较

Table 1. Comparison of baseline characteristics 例(%), X ± S, M(P₂₅, P₇₅)

项目	健康组(60例)	CCD组(60例)	AMI组(60例)	F/H/χ²	P
一般资料
年龄/岁	55.00(50.25，61.60)	59.00(53.00，65.00)	56.50(47.00，69.50)	4.138	0.126
男性	31(31.1)	39(34.8)	42(37.5)	4.585	0.101
BMI/(kg/m²)	25.17±3.65	25.82±3.17	26.05±2.95	1.169	0.313
吸烟史	7(13.5)	19(36.5)	26(50.0)	14.980	0.001
收缩压/mmHg	118.33±16.21	130.02±19.59	124.02±19.78	5.921	0.003
Gensini评分		8.50(6.00，14.00)	67.00(42.50，84.75)	116.060	< 0.001
血常规
白细胞计数/(×10⁹/L)	5.81(4.79，7.07)	6.59(5.66，8.13)	9.80(8.16，11.39)	43.330	< 0.001
单核细胞计数/(×10⁹/L)	0.37(0.29，0.51)	0.47(0.39，0.65)	0.69(0.46，1.38)	26.560	< 0.001
淋巴细胞计数/(×10⁹/L)	1.71(1.04，2.39)	1.68(1.24，2.79)	1.73(1.23，2.54)	0.178	0.915
中性粒细胞计数/(×10⁹/L)	3.55(2.89，4.35)	3.99(3.18，5.38)	6.70(5.26，9.27)	54.100	< 0.001
CRP/(mg/dL)	1.55(0.81，3.16)	1.17(0.60，2.32)	2.16(0.99，5.96)	5.650	0.059
血生化结果
Cr/(μmol/L)	59.30(50.95，70.73)	73.8(64.23，81.73)	71.85(61.03，81.78)	9.379	0.009
CK-MB /(U/L)	1.35(0.73，2.51)	2.33(1.08，13.79)	11.30(2.56，64.83)	28.130	< 0.001
FBG/(mmol/L)	4.64(4.25，5.46)	5.40(4.53，6.00)	6.16(5.45，7.84)	32.130	< 0.001
TC/(mmol/L)	4.21(3.49，4.91)	4.22(3.27，5.14)	4.33(3.72，5.23)	0.400	0.819
TG/(mmol/L)	1.36(1.01，1.55)	1.45(1.04，1.96)	1.29(0.97，1.69)	0.845	0.655
LDL-C/(mmol/L)	2.58±0.79	2.65±0.94	2.81±1.02	1.003	0.369
HDL-C/(mmol/L)	1.02(0.88，1.19)	0.97(0.85，1.17)	0.99(0.80，1.15)	1.600	0.449
口服药物
阿司匹林	5(1.0)	50(49.0)	51(50.0)	115.090	< 0.001
他汀类	3(0.9)	57(49.0)	58(50.0)	154.830	< 0.001
β受体阻滞剂	1(0.1)	39(43.8)	49(55.1)	85.520	< 0.001
1 mmHg=0.133 kPa。

下载: 导出CSV

表 2 患者miR-126与MHR水平比较

Table 2. Comparison of miR-126 and MHR levels M(P₂₅, P₇₅)

项目	健康组(60例)	CCD组(60例)	AMI组(60例)	F	P
miR-126	0.87(0.50，1.32)	1.01(0.54，1.92)	0.33(0.11，0.61)	25.60	< 0.001
MHR	0.36(0.25，0.53)	0.50(0.41，0.79)	0.73(0.45，1.52)	22.53	< 0.001

下载: 导出CSV

表 3 AMI发生的危险因素

Table 3. Risk factors for AMI occurrence

变量	单因素logistics回归分析			多因素logistic回归分析
变量	OR	95%CI	P	OR	95%CI	P
吸烟史	0.796	0.370~1.712	0.559
BMI	0.998	0.888~1.120	0.969
收缩压	1.014	0.996~1.033	0.132
Gensini评分	0.950	0.930~0.970	< 0.001	0.949	0.925~0.974	< 0.001
Cr	0.998	0.978~1.019	0.846
FBG	0.780	0.636~0.957	0.017	0.879	0.665~1.163	0.367
miR-126	9.728	3.590~26.360	< 0.001	6.995	2.126~23.018	0.001
MHR	0.431	0.211~0.884	0.022	4.527	1.145~17.895	0.031

下载: 导出CSV

参考文献(23)

[1]	Mensah GA, Fuster V, Roth GA. A Heart-Healthy and Stroke-Free World: Using Data to Inform Global Action[J]. J Am Coll Cardiol, 2023, 82(25): 2343-2349. doi: 10.1016/j.jacc.2023.11.003
[2]	Zhu Y, Wang Y, Shrikant B, et al. PURE-China Investigators. Socioeconomic disparity in mortality and the burden of cardiovascular disease: analysis of the Prospective Urban Rural Epidemiology(PURE)-China cohort study[J]. Lancet Public Health, 2023, 8(12): e968-e977. doi: 10.1016/S2468-2667(23)00244-X
[3]	唐建军, 金啸天. 急性心肌梗死机械并发症治疗进展[J]. 临床心血管病杂志, 2023, 39(7): 498-500. doi: 10.13201/j.issn.1001-1439.2023.07.003
[4]	Stampouloglou PK, Siasos G, Bletsa E, et al. The Role of Cell-derived Microparticles in Cardiovascular Diseases: Current Concepts[J]. Curr Pharm Des, 2022, 28(21): 1745-1757. doi: 10.2174/1381612828666220429081555
[5]	Feng S, Chen JW, Shu XY, et al. Endothelial microparticles: A mechanosensitive regulator of vascular homeostasis and injury under shear stress[J]. Front Cell Dev Biol, 2022, 10: 980112. doi: 10.3389/fcell.2022.980112
[6]	Ghafouri-Fard S, Gholipour M, Taheri M. Role of MicroRNAs in the Pathogenesis of Coronary Artery Disease[J]. Front Cardiovasc Med, 2021, 8: 632392. doi: 10.3389/fcvm.2021.632392
[7]	Ewelina K, Eljaszewicz A, Kazimierczyk R, et al. Altered microRNA dynamics in acute coronary syndrome[J]. Postepy Kardiol Interwencyjnej, 2020, 16(3): 287-293.
[8]	Jiang M, Yang J, Zou H, et al. Monocyte-to-high-density lipoprotein-cholesterol ratio(MHR)and the risk of all-cause and cardiovascular mortality: a nationwide cohort study in the United States[J]. Lipids Health Dis, 2022, 21(1): 30. doi: 10.1186/s12944-022-01638-6
[9]	Williams H, Mack CD, Li SCH, et al. Nature versus Number: Monocytes in Cardiovascular Disease[J]. Int J Mol Sci, 2021, 22(17): 9119. doi: 10.3390/ijms22179119
[10]	Liu C, Dhindsa D, Almuwaqqat Z, et al. Association Between High-Density Lipoprotein Cholesterol Levels and Adverse Cardiovascular Outcomes in High-risk Populations[J]. JAMA Cardiol, 2022, 7(7): 672-680. doi: 10.1001/jamacardio.2022.0912
[11]	Byrne RA, Rossello X, Coughlan JJ, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes[J]. Eur Heart J, 2023, 44(38): 3720-3826. doi: 10.1093/eurheartj/ehad191
[12]	Writing Committee Members, Virani SS, Newby LK, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines[J]. J Am Coll Cardiol, 2023, 82(9): 833-955. doi: 10.1016/j.jacc.2023.04.003
[13]	Rampidis GP, Benetos G, Benz DC, et al. A guide for Gensini Score calculation[J]. Atherosclerosis, 2019, 287: 181-183. doi: 10.1016/j.atherosclerosis.2019.05.012
[14]	中国心血管病风险评估和管理指南编写联合委员会. 中国心血管病风险评估和管理指南[J]. 中国循环杂志, 2019, 34(1): 4-28.
[15]	霍勇, 郑博, 刘耀琨. 冠心病介入诊疗最新临床研究进展[J]. 临床心血管病杂志, 2023, 39(5): 327-331. doi: 10.13201/j.issn.1001-1439.2023.05.001
[16]	王乃赓, 郝建红, 罗振国. 缺血再灌注诱导内皮细胞损伤相关机制与治疗的研究进展[J]. 医学综述, 2022, 28(8): 1568-1572. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS202208020.htm
[17]	Shu Z, Tan J, Miao Y, et al. The role of microvesicles containing microRNAs in vascular endothelial dysfunction[J]. J Cell Mol Med, 2019, 23(12): 7933-7945. doi: 10.1111/jcmm.14716
[18]	Kabłak-Ziembicka A, Badacz R, Przewłocki T. Clinical Application of Serum microRNAs in Atherosclerotic Coronary Artery Disease[J]. J Clin Med, 2022, 11(22): 6849. doi: 10.3390/jcm11226849
[19]	Yuan Y, Ma Y, Aili Z, et al. Reductions in extracellular vesicle-associated microRNA-126 levels in coronary blood after acute myocardial infarction: A retrospective study[J]. Front Cardiovasc Med, 2022, 9: 1046839. doi: 10.3389/fcvm.2022.1046839
[20]	古力斯坦·艾斯卡尔, 布祖克拉·阿布都艾尼, 吐尔孙阿依·依斯米提, 等. 急性冠脉综合征患者微粒中miR-126与NLR间的关系及其临床意义[J]. 临床急诊杂志, 2021, 22(11): 720-726. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC202111004.htm
[21]	Zhang DP, Baituola G, Wu TT, et al. An elevated monocyte-to-high-density lipoprotein-cholesterol ratio is associated with mortality in patients with coronary artery disease who have undergone PCI[J]. Biosci Rep, 2020, 40(8): BSR20201108. doi: 10.1042/BSR20201108
[22]	Rahman MS, Murphy AJ, Woollard KJ. Effects of dyslipidaemia on monocyte production and function in cardiovascular disease[J]. Nat Rev Cardiol, 2017, 14(7): 387-400. doi: 10.1038/nrcardio.2017.34
[23]	Wang KY, Zheng YY, Wu TT, et al. Predictive Value of Gensini Score in the Long-Term Outcomes of Patients With Coronary Artery Disease Who Underwent PCI[J]. Front Cardiovasc Med, 2022, 8: 778615. doi: 10.3389/fcvm.2021.778615