临床与病理杂志2025，Vol.45Issue(4)：433-442,10.DOI:10.11817/j.issn.2095-6959.2025.240899
外周血TGF-β、lncRNA ATB与急性STEMI患者PCI术后心肌缺血再灌注损伤的相关性
Correlation between peripheral blood TGF-β,lncRNA ATB,and myocardial ischemia-reperfusion injury in acute STEMI patients after PCI
摘要
Abstract
Objective:Transforming growth factor-beta(TGF-β)and long non-coding RNA ATB(lncRNA ATB)are induced during acute myocardial infarction and co-regulate pathological processes such as inflammation and apoptosis,playing critical roles in disease onset and progression.This study aims to investigate the expression levels of TGF-β and lncRNA ATB in the peripheral blood of patients with myocardial ischemia-reperfusion injury(MIRI)and explore their correlation. Methods:A total of 156 patients diagnosed with acute ST-segment elevation myocardial infarction(STEMI)and receiving primary percutaneous coronary intervention(PCI)at the Affiliated People's Hospital of Jiangsu University between July 2023 and August 2024 were enrolled.Based on whether MIRI occurred after reperfusion of the culprit vessel,patients were divided into a MIRI group(n=76)and a non-MIRI group(n=80).Clinical characteristics and the relative expression levels of plasma TGF-β and lncRNA ATB in leukocytes were compared.Spearman correlation analysis was used to assess the relationship between TGF-β,and lncRNA ATB,and inflammatory and myocardial injury markers.Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for MIRI.The diagnostic value of TGF-β,lncRNA ATB,and their combination was evaluated using receiver operating characteristic(ROC)curve analysis. Results:TGF-β and lncRNA ATB levels were significantly higher in the MIRI group compared to the non-MIRI group.Both systolic and diastolic blood pressures were significantly lower in the MIRI group,and a higher proportion of culprit vessels were located in the right coronary artery(all P<0.05).No significant differences were found between groups in age,gender,history of hypertension,diabetes,smoking,body mass index,door-to-wire time,or culprit lesions in the left anterior descending or circumflex arteries(all P>0.05).On the day after PCI,leukocyte count,neutrophil count,high-sensitivity C-reactive protein(hs-CRP),platelet count,and cardiac troponin I(cTnI)levels were significantly higher in the MIRI group(all P<0.05).No significant differences were observed in monocyte count,lymphocyte count,N-terminal pro-B-type natriuretic peptide(NT-proBNP),or left ventricular ejection fraction between the 2 groups(all P>0.05).Spearman analysis showed that TGF-β was positively correlated with leukocyte count,neutrophil count,monocyte count,lymphocyte count,platelet count,cTnI,and NT-proBNP(all P<0.05);lncRNA ATB was positively correlated with leukocyte count,neutrophil count,and NT-proBNP(all P<0.05);and TGF-β was positively correlated with lncRNA ATB(P<0.001).Multivariate logistic regression analysis indicated TGF-β,lncRNA ATB,right coronary artery,leukocyte count,hs-CRP,and cTnI as independent risk factors for MIRI(OR=1.208,1.512,3.142,1.164,1.047,and 1.033 respectively;all P<0.05),while diastolic pressure was a protective factor(OR=0.920,P<0.05).ROC curve analysis indicated that the area under the curve(AUC)for TGF-β,lncRNA ATB,and their combination in diagnosing MIRI was 0.751,0.767,and 0.799,respectively,with sensitivities of 52.6％,72.4％and 82.9％and specificities of 90.0％,76.2％,and 71.2％,respectively.No statistically significant differences were found in AUCs among the three(all P>0.05). Conclusion:TGF-β and lncRNA ATB are independent risk factors for MIRI and are significantly associated with its occurrence in STEMI patients after PCI,suggesting their potential involvement in inflammatory processes of MIRI.关键词
转化生长因子-β/长链非编码RNA ATB/急性ST段抬高型心肌梗死/经皮冠状动脉介入治疗/心肌缺血再灌注损伤Key words
transforming growth factor-beta/long non-coding RNA ATB/acute ST-segment elevation myocardial infarction/percutaneous coronary intervention/myocardial ischemia-reperfusion injury引用本文复制引用
姬林娟,姚永伟,田欣,王聪,芮涛,王好,俞捷..外周血TGF-β、lncRNA ATB与急性STEMI患者PCI术后心肌缺血再灌注损伤的相关性[J].临床与病理杂志,2025,45(4):433-442,10.基金项目
国家自然科学基金(82172172) （82172172）
江苏省镇江市社会发展重点基金(SH2023028) （SH2023028）
江苏省镇江市心肌疾病临床医学重点实验室基金(SS2023010) （SS2023010）
镇江市第一人民医院院内科研基金(YL2023004).This work was supported by the National Natural Science Foundation(82172172),Zhenjiang Social Development Key Foundation of Jiangsu Province(SH2023028),Zhenjiang Key Laboratory of Clinical Medicine of Myocardial Diseases Foundation of Jiangsu Province(SS2023010),and Zhenjiang First People's Hospital Research Foundation of Jiangsu Province(YL2023004),China. （YL2023004）
