CAJ | 학술논문

目的了解微RNA-92a(miR-92a)在ST段抬高型心肌梗死(STEMI)发生发展中的表达,以及经皮冠状动脉介入治疗(PCI)对循环miR-92a表达的影响,探讨miR-92a在冠心病临床应用中的可能性.方法 82例STEMI患者及116例慢性稳定型心绞痛(SAP)患者按照是否接受PCI治疗分为STEMI行PCI治疗组(58例)、STEMI未行PCI治疗组(24例)及SAP未行PCI治疗组(116例)3组,分析比较其循环miR-92a表达的差异.结果 STEMI未行PCI患者入院次日循环miR-92a表达水平高于SAP未行PCI者(0.286 9±0.816 7比-0.055 5±0.985 5,P=0.121).PCI治疗24 h后STEMI行PCI患者循环miR-92a表达水平低于STEMI未行PCI者(-0.032 4±0.956 3比0.286 9±0.816 7,P=0.156).SAP未行PCI患者出院存活率显著高于STEMI未行PCI者(100.0％比75.0％,P=0.001),STEMI行PCI患者出院存活率高于STEMI未行PCI者(89.7％比75.0％,P=0.088).结论 STEMI患者循环miR-92a表达增高;PCI治疗能降低STEMI患者循环miR-92a表达；miR-92a表达下调的STEMI患者出院时存活率高于表达上调的STEMI患者.miR-92a很可能具有用于诊断或评估STEMI危险度、提高急性心肌梗死高危患者筛选的敏感性与准确性以及进行干预治疗的临床实际应用价值.
목적 료해미RNA-92a(miR-92a)재ST단태고형심기경사(STEMI)발생발전중적표체,이급경피관상동맥개입치료(PCI)대순배miR-92a표체적영향,탐토miR-92a재관심병림상응용중적가능성.방법 82례STEMI환자급116례만성은정형심교통(SAP)환자안조시부접수PCI치료분위STEMI행PCI치료조(58례)、STEMI미행PCI치료조(24례)급SAP미행PCI치료조(116례)3조,분석비교기순배miR-92a표체적차이.결과 STEMI미행PCI환자입원차일순배miR-92a표체수평고우SAP미행PCI자(0.286 9±0.816 7비-0.055 5±0.985 5,P=0.121).PCI치료24 h후STEMI행PCI환자순배miR-92a표체수평저우STEMI미행PCI자(-0.032 4±0.956 3비0.286 9±0.816 7,P=0.156).SAP미행PCI환자출원존활솔현저고우STEMI미행PCI자(100.0％비75.0％,P=0.001),STEMI행PCI환자출원존활솔고우STEMI미행PCI자(89.7％비75.0％,P=0.088).결론 STEMI환자순배miR-92a표체증고;PCI치료능강저STEMI환자순배miR-92a표체；miR-92a표체하조적STEMI환자출원시존활솔고우표체상조적STEMI환자.miR-92a흔가능구유용우진단혹평고STEMI위험도、제고급성심기경사고위환자사선적민감성여준학성이급진행간예치료적림상실제응용개치.
Objective To examine the expression of circulating microRNA-92a(miR-92a)in patients with ST-segment elevation myocardial infarction(STEMI),and the impact of percutaneous coronary intervention(PCI)on such expression.Methods The level of circulating miR-92a was measured in three groups of patients:58 STEMI patients received PCI,24 STEMI patients received no PCI,and 116 patients with stable angina pectoris(SAP)without PCI.Results On the day next to admission,STEMI patients received no PCI were found to have higher level of circulating miR-92a as compared to SAP patients without PCI(0.286 9±0.816 7 vs.-0.055 5±0.985 5,F=2.438,P=0.121).Twenty-four hours after the PCI,the level of circulating miR-92a in STEMI patients received the procedure was lower than those without it (-0.032 4±0.956 3 vs.0.286 9±0.816 7,F=2.054,P=0.156).The SAP patients(without PCI)had higher survival rate as compared to the STEMI patients without PCI(100.0％ vs.75.0％ P=0.001),and the survival rate in STEMI patients received PCI was higher than those without it(89.7％ vs.75.0％,P=0.088).Conclusions In STEMI patients,the expression of circulating miR-92a is up-regulated.PCI therapy may suppress such up-regulation.Survival rate is higher in patients showing down-regulation of miR-92a.Our data suggest that miR-92a might have potential for diagnosis and therapeutic application in the prevention and treatment of STEMI.