摘要
目的研究血清lncRNA p21表达水平与经皮冠状动脉介入术(PCI)治疗急性心肌梗死患者预后的关系。方法选取2018年1月至2020年12月沭阳县中医院收治的102例PCI治疗的急性心肌梗死患者,患者术后随访1年,根据急性生理与慢性健康评分(APACHE-Ⅱ)将患者分为预后良好组和预后不良组,预后良好组72例,预后不良组30例。比较两组患者性别、身体质量指数(BMI)、高血压等一般临床资料,比较两组入院时肌钙蛋白(c Tnl)、肌酸激酶同工酶(CK-MB)水平以及治疗前后血清lncRNA p21表达情况,分析血清lncRNA p21表达与患者预后的关系。结果预后良好组患者合并慢性阻塞性肺疾病(COPD)、早发冠心病、合并自身免疫疾病百分比低于预后不良组,差异有统计学意义(P<0.05)。预后良好组入院时cTnl、CK-MB水平均低于预后不良组,差异有统计学意义(P<0.05)。治疗前预后良好组lncRNA p21表达水平高于预后不良组,治疗后两组lncRNA p21表达水平升高且预后良好组高于预后不良组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示:高水平lncRNA p21与糖酵解酶的比值(lncRNA p21/GAPDH)表达是PCI治疗急性心肌梗死患者预后的保护因素,预后>60岁、合并COPD、早发冠心病、合并自身免疫疾病以及高水平CK-MB是PCI治疗急性心肌梗死患者预后的危险因素(P<0.05)。结论LncRNA-p21低表达可以加重心肌细胞及内皮细胞受损程度,内皮细胞损伤可能加重冠脉狭窄,不利于急性心肌梗死患者预后,血清高水平lncRNA p21表达水平是PCI治疗急性心肌梗死预后的保护因素。
Objective To investigate the relationship between serum lncRNA p21 expression level and prognosis of patients with acute myocardial infarction treated with percutaneous coronary intervention(PCI).Methods A total of 102 patients with acute myocardial infarction treated with PCI in Shuyang County Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were selected.The patients were followed up for 1 year after surgery.According to acute physiology and chronic health evaluation(APACHE-Ⅱ),patients were divided into the good prognosis group and the poor prognosis group,with the good prognosis group of 72 cases and the poor prognosis group of 30 cases.General clinical data such as gender,body mass index(BMI)and hypertension were compared between the two groups.The levels of troponin(cTnl)and creatine kinase isoenzyme(CK-MB)on admission and the expression of serum lncRNA p21 before and after treatment were compared between the two groups,and the relationship between serum lncRNA p21 expression and patient prognosis was analyzed.Results The percentage of patients in the good prognosis group with chronic obstructive pulmonary disease(COPD),early coronary heart disease,and autoimmune disease combination was lower than that in the poor prognosis group,with a statistically significant difference(P<0.05).The cTnl and CK-MB levels on admission were lower than those in the poor prognosis group,with a statistically significant difference(P<0.05).Before treatment,the expression level of lncRNA p21 in the group with good prognosis was higher than that in the group with poor prognosis.After treatment,the expression level of lncRNA p21 in both groups increased and the group with good prognosis was higher than that in the group with poor prognosis.The difference was statistically significant(P<0.05).Logistic regression analysis results showed that the expression of high-level lncRNA p21 to glycolytic enzyme ratio(lncRNA p21/GAPDH)is a protective factor for the prognosis of patients with acute myocardial infarction treated with PCI.The prognosis is>60 years old,combined with COPD,premature coronary heart disease,and combined Autoimmune diseases and high levels of CK-MB are risk factors for the prognosis of patients with acute myocardial infarction treated with PCI(P<0.05).Conclusion The low expression of lncRNA-p21 can aggravate the damage to cardiomyocytes and endothelial cells.Endothelial cell injury may aggravate coronary stenosis,which is not conducive to the prognosis of patients with AMI.High serum lncRNA p21 expression level is a protective factor for the prognosis of AMI treated with PCI.
作者
王亮
李伟
李涛
耿山山
袁国良
WANG Liang;LI Wei;LI Tao;GENG Shanshan;YUAN Guoliang(Department of Cardiology,Shuyang Hospital of Traditional Chinese Medicine,Shuyang,Jiangsu,China,223600)
出处
《分子诊断与治疗杂志》
2024年第1期93-97,共5页
Journal of Molecular Diagnostics and Therapy
基金
江苏省中西医结合老年病防治重点实验室开放课题(202231)。
