现代检验医学杂志2025，Vol.40Issue(5)：28-34,51,8.DOI:10.3969/j.issn.1671-7414.2025.05.006
急性心肌梗死患者PCI术前血清lncRNA XIST,miR-140-3p水平与冠状动脉病变程度及预后的相关性研究
Correlation between Serum lncRNA XIST,miR-140-3p Levels and Degree of Coronary Artery Disease and Prognosis in Patients with Acute Myocardial Infarction before PCI
摘要
Abstract
Objective To investigate the relationship between preoperative serum levels of long noncoding RNA(lncRNA)X inactive specific transcript(XIST)and microRNA(miR)-140-3p in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI)and blood glucose,blood lipids,myocardial injury indexes,degree of coronary artery disease and the occurrence of major adverse cardiovascular events(MACE)within 3 years after surgery.Methods A total of 164 patients with AMI(AMI group)and 148 healthy subjects(healthy group)were selected from Hankuang General Hospital of North China Medical and Health Group from November 2018 to February 2021.Clinical data were collected at admission,and blood glucose,blood lipids,myocardial injury indicators,serum lncRNA XIST and miR-140-3p levels in AMI group before PCI and healthy group during physical examination were detected.According to the degree of coronary artery disease,AMI patients were divided into mild coronary artery disease group(n=33),moderate coronary artery disease group(n=76),and severe coronary artery disease group(n=55).Follow up for 3 years after surgery,AMI patients were divided into MACE group(n=36)and non-MACE group(n=128).Clinical data,preoperative PCI blood glucose,blood lipids,myocardial injury indicators,synergy between percutaneous coronary intervention with TAXUS and cardiac surgery(SYNTAX)score,and serum lncRNA XIST and miR-140-3p expression levels of health group and AMI group,AMI patients with different prognoses within 3 years after PCI were compared.The serum lncRNA XIST and miR-140-3p expression levels of AMI patients with different degrees of coronary artery disease before PCI were compared.The correlation between preoperative PCI serum lncRNA XIST and miR-140-3p with blood glucose,blood lipids,myocardial injury indicators,SYNTAX score in AMI patients,the influencing factors of MACE occurrence,and predicting the value of preoperative PCI serum lncRNA XIST and miR-140-3p in predicting MACE occurrence within 3 years after PCI in AMI patients were analyzed.Results Compared with healthy group,the preoperative PCI fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low density lipoprotein-cholesterol(LDL-C),hypersensitive C-reactive protein(hs-CRP),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin I(cTnI),brain natriuretic peptide(BNP),lncRNA XIST expression levels of AMI group were significantly increased(t=2.426～80.642),and high density lipoprotein-cholesterol(HDL-C),left ventricular ejection fraction(LVEF)and miR-140-3pexpression levels were significantly reduced(t=6.166～66.119),the differences were statistically significant(all P<0.05).Before PCI,the expression levels of serum lncRNA XIST were increased successively,and the expression levels of miR-140-3p were decreased successively in mild,moderate,and severe coronary artery lesions group,the differences were statistically significant(F=174.600,231.138,all P<0.05).The serum lncRNA XIST of AMI patients before PCI was positively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=0.235～0.681,all P＜0.05),and negatively correlated with miR-140-3p,HDL-C and LVEF(r=-0.571,-0.262,-0.513,all P＜0.05).miR-140-3p was negatively correlated with FPG,TC,TG,LDL-C,hs-CRP,CK-MB,Hcy,cTnI,BNP and SYNTAX scores(r=-0.672～-0.209,all P＜0.05),and positively correlated with HDL-C and LVEF(r=0.245,0.524,all P＜0.05).Compared with non-MACE group,the hs-CRP,CK-MB,Hcy,cTnI,BNP,SYNTAX scores and lncRNA XIST expression levels before PCI in MACE group were significantly increased(t=3.032～26.330),while the LVEF and miR-140-3p expression levels were significantly reduced(t=2.821,13.318),the differences were statistically significant(all P<0.05).LVEF and miR-140-3p were independent protective factors for MACE in AMI patients within 3 years after PCI(Wald χ2=6.098,7.851,all P＜0.05),while CK-MB,Hcy,cTnI,BNP,SYNTAX score and lncRNA XIST were independent risk factors for MACE in AMI patients within 3 years after PCI(Wald χ2=4.263～7.853,all P＜0.05).Compared with the area under curve(AUC)of serum lncRNA XIST and miR-140-3p before PCI separately predicting MACE occurrence within 3 years after PCI in AMI patients,the combined prediction of MACE occurrence within 3 years after PCI in AMI patients was higher,and the differences were statistically significant(Z=2.059,2.017,all P<0.05).Conclusion The expression of lncRNA XIST in the serum of AMI patients is increased while the expression of miR-140-3p is decreased.Both are associated with blood glucose,blood lipids myocardial injury indicators,degree of coronary artery disease,and the occurrence of MACE within three years after PCI.They have high value in predicting the occurrence of MACE within three years after PCI surgery.关键词
急性心肌梗死/经皮冠状动脉介入治疗/长链非编码RNA X染色体失活特异转录因子/微小核糖核酸-140-3pKey words
acute myocardial infarction/percutaneous coronary intervention/long noncoding RNA X inactive specific transcript/microRNA-140-3p分类
医药卫生引用本文复制引用
范源洁,张亚云,牛英春..急性心肌梗死患者PCI术前血清lncRNA XIST,miR-140-3p水平与冠状动脉病变程度及预后的相关性研究[J].现代检验医学杂志,2025,40(5):28-34,51,8.基金项目
河北省医学科学研究课题计划项目(20231698). （20231698）
