MicroRNA-29a与冠心病心绞痛患者血管内皮损伤及斑块不稳定性的相关性

Correlation between microRNA-29a and vascular endothelial damage and plaque instability in patients with coronary heart disease and angina pectoris

摘要:

目的 探讨microRNA-29a（miR-29a）与冠心病心绞痛患者血管内皮损伤及斑块不稳定性的相关性。方法 连续纳入2020年4月—2022年6月于青岛市中医医院住院的冠心病患者120例，入院后均完善冠状动脉CT血管成像检查，测定冠状动脉斑块CT值，实时荧光定量聚合酶链反应（qRT-PCR）检测外周静脉血循环miR-29a表达，通过酶联免疫吸附试验检测血管内皮细胞特异性分子-1（ESM-1）、内皮素-1（ET-1）、一氧化氮（NO）、肿瘤坏死因子-α（TNF-α）及细胞间黏附分子-1（ICAM-1）水平，根据miR-29a中位数（miR-29a=1.13）将患者分为高miR-29a组及低miR-29a组，分析两组患者冠状动脉斑块稳定性、外周静脉血中血管内皮活性物质表达及炎症指标变化。结果 两组患者临床基本资料无差异，具有可比性；高miR-29a组的ESM-1、ET-1、NO、TNF-α均高于低miR-29a组（P <0.05）；斑块不稳定患者miR-29a水平高于斑块稳定患者（P <0.05），不稳定型心绞痛患者miR-29a水平高于稳定型心绞痛患者（P <0.05）；软斑块患者miR-29a mRNA相对表达量高于纤维斑块和钙化斑块患者（P <0.05）；Pearson相关性分析结果显示，miR-29a与ET-1、TNF-α及ESM-1呈正相关（r =0.471、0.605和0.328，P =0.000、0.041和0.000），与NO呈负相关（r =-0.291，P =0.034）。结论 miR-29a与冠心病心绞痛患者冠状动脉血管内皮损伤及斑块不稳定性具有相关性，miR-29a表达越高，血管内皮损伤可能越严重，斑块不稳定性风险越大。

Abstract:

Objective To investigate the correlation of microRNA-92a (miR-92a) with endothelial vascular injury and plaque properties in patients with coronary heart disease and angina pectoris.Methods A total of 120 patients with coronary heart disease who were admitted to the Department of Cardiovascular Medicine in our hospital from April 2020 to June 2022 were consecutively enrolled. After admission, coronary artery imaging examinations were completed, the CT values of coronary plaques were measured, and peripheral venous blood was drawn from the patients. Circulating miR-29a levels were detected by real-time fluorescent quantitative PCR, and endothelial cell-specific molecule-1 (ESM-1), endothelin-1 (ET-1), nitric oxide (NO), the levels of tumor necrosis factor-α (TNF-α) and intercellular adhesion molecule-1 (ICAM-1). According to the median of miR-29a (miR-29a = 1.13), patients were divided into high miR-29a group. In the low miR-29a group, the stability of coronary plaques, the expression of vascular endothelial active substances in peripheral blood and the changes of inflammatory indexes were analyzed.Results There was no significant difference in basic clinical data between the two groups, and they were comparable; ET-1, TNF-α, ESM-1 in the high miR-29a group were significantly higher than those in the low miR-92a group; comparison shows that the level of miR-29a in patients with unstable plaque is significantly higher than that in patients with stable plaque (P < 0.05), and the level of miR-29a in patients with unstable angina is significantly higher than that in stable plaque patients with angina pectoris (P < 0.05); patients with soft plaques had significantly higher levels of miR-29a than those with fibrous plaques and calcified plaques (P < 0.05); Pearson correlation analysis indicated that miR-29a was associated with ET-1 (r = 0.471, P =0.000), TNF-α (r = 0.605, P =0.041) and ESM-1 (r = 0.328, P =0.000) were positively correlated, but negatively correlated with NO (r = -0.291, P =0.034).Conclusion miR-29a was associated with coronary artery disease in patients with coronary heart disease vascular endothelial injury and plaque stability are correlated. The higher the level, the more severe the vascular endothelial injury and the greater the risk of plaque instability.