目的: 检测冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease, CHD)患者血浆中miR-145的表达,探讨其作为评估急性冠脉综合征(acute coronary syndrome, ACS)患者病变严重程度、斑块易损性指标的可行性。方法: 选取2023年11月-2024年11月于包头市中心医院心内科住院并行冠状动脉影像学检查的患者120例,其中急性心肌梗死(acute myocardial infarction, AMI)、不稳定型心绞痛(unstable angina, UA)患者各30例纳入ACS组;稳定型心绞痛(stable angina pectoris, SAP)组30例;血管无异常者30例纳入对照组。应用实时定量PCR技术(RT-qPCR)检测血浆miR-145相对表达量,借助光学相干断层成像技术(optical coherence tomography, OCT)观察并记录罪犯斑块形态、性质。结果: (1)与对照组相比,SAP组、ACS组血浆miR-145表达水平均明显降低(P＜0.001);且与SAP组比较,ACS组血浆miR-145表达水平明显降低(P＜0.001)。(2)miR-145表达水平与罪犯斑块最小纤维帽厚度呈正相关(P＜0.001),与斑块最大脂质弧度、最大纤维斑块长度呈负相关(P＜0.001),与最小管腔面积无明显相关性(P＞0.05)。结论: :血浆miR-145对ACS患者病变严重程度、斑块易损性的评估具有预测价值。
Objective: To investigate the differential expression of plasma miR-145 in patients with coronary atherosclerotic heart disease (CHD) and to evaluate its feasibility as an indicator for assessing disease severity and plaque vulnerability in patients with acute coronary syndrome (ACS). Methods: A total of 120 patients admitted to the Department of Cardiology, Baotou Central Hospital from November 2023 to November 2024 and undergoing coronary imaging were included. The ACS group consisted of 30 patients with acute myocardial infarction (AMI) and 30 with unstable angina (UA). The control group comprised 30 patients with stable angina pectoris (SAP) and 30 individuals with no vascular abnormalities. The relative expression of plasma miR-145 was measured by real-time quantitative polymerase chain reaction (RT-qPCR). Optical coherence tomography (OCT) was utilized to observe and characterize culprit plaques. Results: (1) Compared with the control group, plasma miR-145 expression was significantly decreased in both the SAP and ACS groups (P＜0.001); Furthermore, miR-145 expression was significantly lower in the ACS group than in the SAP group (P＜0.001). (2) MiR-145 expression was positively correlated with the minimum fibrous cap thickness of culprit plaques (P＜0.001), and negatively correlated with maximum lipid arc and maximum fibrous plaque length (P＜0.001), while no significant correlation was observed with minimum lumen area (P＞0.05). Conclusion: Plasma miR-145 shows predictive value for evaluating disease severity and plaque vulnerability in patients with ACS.
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