| Objective:Exploration the relationship between the expressions of micro RNA-21(miR-21),micro RNA-34a(miR-34a),micro RNA-146a(miR-146a)and micro RNA-155(miR-155)from monocytes and in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)by analysis changes of the expression of which from monocytes in peripheral blood in patients after PCI.Methods:A total of 90 patients who were followed up after PCI from the department of cardiology of TEDA International Cardiovascular Hospital of Tianjin from October 2015 to April 2017 were registered for this study.All patients were reviewed coronary artery angiography(CAG),according to the results of CAG,38 patients with diameter stenosis of main coronary artery(left main artery,left anterior descending artery,left circumflex artery and right coronary artery)reaching or exceeding 50% were serviced as ISR group.52 patients with diameter stenosis of main coronary artery less than 50% were serviced as insignificant lesion group.And during the same period,64 volunteers with non-coronary artery disease from this hospital as control group.The venous blood of all subjects was collected and monocytes were extracted.1 The expressions of miR-21,miR-34 a from monocytes in three groups(37 cases in ISR group,51 cases in insignificant lesion group,60 cases in control group)were analyzed by real-time fluorescent quantitative PCR(RT-q PCR).Difference in baseline data levels and the expression levels of miR-21 and miR-34 a in three groups were compared.Spearman correlation analysis was performed.Multivariate Logistic Regression model was used to evaluate the influencing factor of ISR after PCI.The diagnostic values of miR-21 and it combination with hypertension,triglyceride(TG)and high-density lipoprotein cholesterol(HDL-C)in ISR after PCI were analyzed by receiver operating characteristic(ROC)curve.2 The expressions of miR-146 a,miR-155 from monocytes in three groups(34 cases in ISR group,46 cases in insignificant lesion group,62 cases in control group)were analyzed.Difference in baseline data levels and the expression levels of miR-146 a and miR-155 in three groups were compared.Spearman correlation analysis was performed.Multivariate Logistic Regression and ROC curve were used to explore the relationship between expression of miR-146 a,miR-155 and ISR after PCI.Results:1 There were significant difference in miR-21 expression among three groups(ISR group,insignificant lesion group and control group)(Hc=21.661,P<0.01).The expression level of miR-21 were higher in ISR group than that in insignificant lesion group(Z=-2.198,P<0.05)and control group(Z=-4.530,P<0.001).There were statistically correlation between hypertension(r=0.194,P<0.05),TG(r=0.171,P<0.05),HDL-C(r=-0.289,P<0.05)and expression of miR-21 from monocytes in ISR group.Multiple Logistic Regression showed that miR-21 from monocytes was an independent risk factor for ISR after PCI.The area under curve(AUC),sensitivity and specificity were 0.78,75.7% and 71.2% respectively by ROC curve in diagnosing ISR for expression of miR-21 from monocytes,and AUC,sensitivity and specificity were 0.846,73.0% and 88.1% respectively for expression of miR-21 combination with hypertension,TG and HDL-C.The expression of miR-21 from monocytes combination with hypertension,TG and HDL-C have more efficiency than only expression of miR-21 in the diagnosis of ISR.2 There was no significant difference in the expression of miR-34 a among three groups(Hc=1.118,P>0.05).3 There was statistically significant difference in the expression of miR-146 a among three groups(Hc=16.668,P<0.001).The expression level of miR-146 a was significant higher in ISR group and insignificant lesion group than that in control group respectively(Z=-3.427,P<0.001;Z=-3.285,P<0.001).There was no significant difference in the expression of miR-146 a between in ISR group and in insignificant lesion group(Z=-0.04,P>0.05).There were statistically correlation between hypertension(r=0.344,P<0.05),TG(r=0.274,P<0.05)and expression of miR-146 a from monocytes.Multiple Logistic Regression showed that expression of miR-146 a from monocytes was a risk factor for ISR after PCI.ROC curve indicated that miR-146 a from monocytes had certain value in the diagnosis of ISR after PCI(AUC was 0.750,sensitivity was 76.0%,specificity was 66.0%).4 There was statistically significant difference in the expression of miR-155 among three groups(Hc=21.327,P<0.001).The expression of miR-155 from monocytes was significantly higher than that in insignificant lesion group(Z=-2.355,P<0.05)and control group(Z=-4.505,P<0.001).The expressions of miR-155 from monocytes was positively related to TG(r=0.246,P<0.05).Multiple Logistic Regression and ROC curve suggestion that the expression of miR-155 was the risk effect of ISR after PCI and it had a certain value in the diagnosis of ISR after PCI(AUC was 0.779,sensitivity was 70.6%,specificity was 74.2%).Conclusions:1 The expression levels of miR-21 and miR-155 from monocytes were significantly higher in ISR group than that in insignificant lesion group and control group,and they were the independent risk effects of ISR after PCI.2 There was no statistically significant difference in the expression of miR-34 a among ISR group,insignificant lesion group and control group and there was no significant relationship between the expression of miR-34 a and process of ISR.3 The expression level of miR-146 a from monocytes in ISR group and insignificant lesion group were increased than that in control group respectively and miR-146 a was the influencing factor of ISR after PCI and it had a certain value in the diagnosis of ISR after PCI.4 The high expression of miR-21 from monocytes with hypertension,high level of TG and low level of HDL-C had a higher efficiency in the diagnosis of ISR after PCI,and it is suggested that miR-21 from monocytes combination with hypertension,TG and HDL-C can play a role in early prevention and early intervention of ISR after PCI. |
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