CASC2和miRNA-21在STEAMI病人急诊PCI前后外周血中的表达变化

摘要

Objective To analyze the expressions of long non-coding RNA cancer susceptibility candidate 2(CASC2)and microRNA-21 (miRNA-21)in peripheral blood of patients with ST-elevation acute myocardial infarction(STEAMI)undergoing emergency percutaneous coronary intervention(PCI),and to investigate the clinical value of CASC2 and miRNA-21 in STEAMI.Methods From December 2016 to May 2017,55 patients with STEAMI who underwent emergency PCI in the Department of Cardiology of Weihai Central Hospital affiliated to Qingdao University were selected as STEAMI group,and32 healthy subjects without STEAMI were included in the control group.The patients in STEAMI group were divided into myocardial ischemia-reperfusion injury(MIRI)group(13 cases)and non-MIRI group(42 cases)according to whether or not MIRI occurred after PCI.The expressions of peripheral CASC2and miRNA- 21 were detected by real-time fluorescence quantitative polymerase chain reaction.The correlation between CASC2,miRNA-21, and cardiac troponin T(cTnT)and high sensitive C reactive protein(hs-CRP)was analyzed.Results The expressions of CASC2 and miRNA-21 in STEAMI group before and after PCI were significantly higher than those in control group(P <0.05).The expressions of CASC2 and miRNA-21in MIRI group were lower than non-MIRI group(P <0.05).The expressions of CASC2,miRNA-21, and cTnT were significantly correlated in patients with STEAMI after PCI(r=0.35,P =0.04;r=0.45,P =0.03),and had no correlation with hs-CRP(r=0.12,P =0.32;r=0.22,P =0.45).There was a positive correlation between CASC2 and miRNA-21in patients with STEAMI after PCI(r=0.33,P =0.04).Conclusion CASC2 and miRNA-21 may be involved in the process of MIRI in STEAMI.CASC2 and miRNA-21 can predict MIRI.%目的 观察急性ST段抬高型心肌梗死(STEAMI)病人行急诊经皮冠状动脉介入(PCI)治疗前后外周血中长链非编码RNA癌易感性候选基因2(CASC2)及微小RNA-21(miRNA-21)的表达及变化,探讨CASC2及miRNA-21在STEAMI中的临床价值.方法 选择2016年12月—2017年5月青岛大学附属威海市中心医院心内科住院行急诊PCI的STEAMI病人55例为STEAMI组,排除STEAMI的32名健康者为健康对照组.根据行PCI后是否发生缺血再灌注损伤(MIRI)将STEAMI组分为MIRI组(13例)及非MIRI组(42例),采用实时定量荧光聚合酶链反应技术检测各组外周静脉血中CASC2及miRNA-21表达水平,分析CASC2、miRNA-21与心肌肌钙蛋白T(cTnT)和超敏C反应蛋白(hs-CRP)的相关性.结果 STEAMI组PCI术前及术后CASC2、miRNA-21表达水平均明显高于健康对照组,差异均有统计学意义(P <0.05).MIRI组CASC2及miRNA-21表达水平均低于非MIRI病人,差异均有统计学意义(P <0.05).STEAMI病人PCI术后外周血CASC2、miRNA-21与cTnT 显著相关(r=0.35,P =0.04;r=0.45,P=0.03),与hs-CRP无相关性(r=0.12,P =0.32;r=0.22,P =0.45);STEAMI病人PCI术后外周血CASC2与miRNA-21呈正相关(r=0.33,P =0.04).结论 CASC2与miRNA-21可能共同参与了STEAMI心肌MIRI,可预测心肌MIRI.