心肌缺血-再灌注患者血清中miR-21 miR-29a的检测及其临床意义

doi:10.3969/j.issn.1002-1949.2019.03.011

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摘要目的探讨心肌缺血-再灌注患者血清中miR-21、miR-29a表达水平及其临床意义。方法回顾性分析本院2016年5月至2017年12月诊治的心肌缺血-再灌注患者80例临床资料，共分为急性ST段抬高性心肌梗死(STEMI)组、急性非ST段抬高性心肌梗死（非STEMI)组、不稳定型心绞痛(UAP)组、稳定型心绞痛(SAP)组，每组各20例，根据心肌缺血-再灌注预后情况将患者分为预后良好组和预后不良组；另选取同期体检的20例健康志愿者纳入对照组。采集所有受试者血清，用荧光实时定量PCR检测术前、术后1 d、术后5 d标本中miR-21、miR-29a表达水平，并进行比较分析。结果术前、术后1 d、术后5 d心肌缺血-再灌注患者血清中miR-21、miR-29a表达水平显著高于对照组（P均<0.05），且术前STEMI组（7.326±1.694，7.984±1.264）和非STEMI组（6.425±1.344,6.583±2.163)高于SAP组（3.324±1.695，3.365±1.635）和UAP组(4.265±0.885,4.324±1.035)，组间比较差异有统计学意义（P均<0.05）。术后1 d心肌缺血-再灌注患者miR-21、miR-29a表达水平升高，术后5 d 表达量下降，组间比较差异有统计学意义（P均<0.05）。对照组三个时间点差异无统计学意义（P>0.05）。预后良好组血清中miR-21、miR-29a均明显低于预后不良组(3.493±1.234 vs.6.484±2.135,3.904±1.272 vs.6.954±1.854,P均<0.05）。结论 miR-21、miR-29a在心肌缺血-再灌注患者的血清中异常表达，联合检测有利于对心肌缺血-再灌注的发生、诊治和预后的评估。

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	张建兴
	江志忠

关键词 ：心肌缺血-再灌注, miR-21, miR-29a, 血清, 预后

基金资助:广东省医学科学技术研究基金项目（A2017497）

作者简介: 张建兴（1978-），男，硕士, 副主任医师，E-mail:993988856@qq.com。

引用本文:

张建兴，江志忠. 心肌缺血-再灌注患者血清中miR-21 miR-29a的检测及其临床意义[J]. 中国急救医学, 2019, 39(3): 254-259.
Zhang Jian-xing, Jiang Zhi-zhong. Detection and clinical significance of serum miR-21 and miR-29a in patients with myocardial ischemia and reperfusion. Chinese Journal of Critical Care Medicine, 2019, 39(3): 254-259.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.03.011 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I3/254

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