| OBJECTIVE:Patients with peripheral blood platelet microRNA146a (miR-146a) and microRNA155 (miR-155) by detecting expression levels in acute coronary syndrome (acute coronary syndrome, ACS), to analyze the possible diagnosis and treatment of acute coronary syndrome value and clinical significance.METHORDS:126 cases of coronary heart disease in line with (coronary heart disease, CHD) patients diagnosed and confirmed by coronary angiography. CHD patients based on clinical manifestations and angiographic results are divided into two groups, with acute coronary syndrome (acute coronary syndrome, ACS) group of 87 patients with stable angina (stable angina pectoris, SAP) group of 39 cases. ACS includes:acute myocardial infarction (acute myocardial infarction, AMI) group of 46 patients; unstable angina (unstable angina pectoris, UAP) group of 41 patients. 43 cases of healthy people as a control group. Gensini scores were based on results of coronary angiography to evaluate coronary stenosis extent, severity and plaque morphology.97 patients underwent coronary CHD 64-slice CT imaging to assess plaque stability. Extraction of peripheral blood, gradient centrifugation and collect platelets, extract Platelet miRNA, using real-time quantitative polymerase chain reaction (Real Time Polymerase Chain Reaction, real time PCR) detection of platelets miR-146a and miR-155 expression level, Comparison of patients in each group platelet expression of two miRNAs whether there are differences.RESULTS:(1) The general clinical data between the groups:sex, age composition, blood pressure, and body mass index, platelet count and drug use, the difference was not statistically significant (P> 0.05). Each group of blood cells parameters, biochemical parameters, blood coagulation parameters, the difference was not statistically significant (P> 0.05).(2) ACS group mainly type II plaque and soft plaque; SAP group is mainly I plaque, Ⅲ plaque, fibrous plaque and calcified plaque.(3) the expression of miR-146a levels of platelets in patients with CHD was significantly higher than non-CHD patients, the difference was statistically significant (P<0.05); and miR-155 expression in platelet CHD patients was significantly lower than that in patients with coronary heart disease, the difference There was statistically significant (P<0.05).(4) the expression level of miR-146a platelet ACS group, SAP group increased compared with the control group, and the ACS group than in SAP group, the difference was statistically significant (P<0.05). The expression levels of miR-155 platelet ACS group, SAP group than the control group, ACS group than in SAP group, the difference was statistically significant (P<0.05).(5) the expression level of miR-146a platelet AMI group than in UAP group, miR-155 expression level was lower than AMI UAP group, the difference was statistically significant (P<0.05).(6) the expression level of miR-146a platelet three disease group, double vessel disease group than single-vessel disease group and control group, the difference was statistically significant (P<0.05). There was no significant difference in single-vessel disease and control groups miR-146a expression levels, the difference was not statistically significant (P> 0.05). Platelet miR-155 expression levels, three disease group, double vessel disease group than the single vessel disease group and control group, the difference was statistically significant (P<0.05). Comparison of single-vessel disease and control groups the expression level of miR-155, the difference was not statistically significant (P> 0.05).(7) platelet miR-146a expression levels of mild lesions, lesions of moderate and severe disease group than in the control group increased, with the exception of mild disease group and the control group showed no significant difference outside (P> 0.05), and severe Lesions were higher than moderate disease group, mild to moderate disease group than disease group, the differences were statistically significant (P<0.05). MiR-155 expression levels of platelet mild, moderate, and severe disease group than in the control group increased, with the exception of mild disease group and the control group showed no significant difference outside (P> 0.05), lower than the moderate and severe lesions lesions group, moderate disease group than mild disease group, the differences were statistically significant (P <0.05).(8) platelet miR-146a expression levels B and C lesions was significantly higher than that in group A lesions and the expression level of the control group, while the expression of miR-155 B and Type C disease group than the A group and the control group lesions The expression levels were significantly lower, the difference was statistically significant (P<0.05), while group A lesions compared with control group, B and C type lesions lesions group, although miR-146a and miR-155 expression levels were changes, but the difference was not statistically significant (P> 0.05).(9) platelet miR-146a expression levels of type Ⅰ, type Ⅱ and type Ⅲ plaque group than in the control group increased (P<0.05), type Ⅱ plaque group miR-146a expression levels of type than the type Ⅰ, Ⅲ plaque group significantly increased, Ⅲ plaque plaque group and Ⅰ group the expression level of miR-146a was not statistically significant (P> 0.05). MiR-155 expression levels of platelet type Ⅰ, type Ⅱ and type Ⅲ plaque group than the control group lower (P<0.05), type Ⅱ plaque group expression levels of miR-155 type than the Ⅰ, Ⅲ plaque group was significantly lower, Ⅲ plaque plaque group and Ⅰ group the expression levels of miR-155 was not statistically significant (P> 0.05).(10) the expression level of miR-146a platelet soft plaque, fibrous plaque, calcified plaque group than the control group increased, the difference was statistically significant (P<0.05), soft plaque and fibrous plaque group than calcified plaque increased, the difference was statistically significant (P<0.05), comparative fibrous plaque group and calcified plaque group miR-146a expression levels, the difference was not statistically significant (P> 0.05). The expression levels of miR-155 platelet soft plaque, fibrous plaque group, calcified plaque group than the control group decreased significantly (P<0.05), soft plaque group than in the fibrous plaque and calcified plaque group lower, the difference was statistically significant (P<0.05), comparative fibrous plaque group and calcified plaque expression levels of miR-155 group, the difference was not statistically significant (P> 0.05) (11) miR-146a levels and Gensini scores were positively correlated ((r=-0.583, P <0.001); miR-155 levels and Gensini score was negatively correlated (r=0.615, P <0.05).CONCLUSION:The severity of platelets miR-146a expression levels and coronary artery stenosis, plaque stability was positively correlated, and miR-155 expression and severity of coronary artery stenosis, plaque stability negatively correlated, suggesting that miR-146a It is a risk factor for coronary heart disease, and miR-155 as a protective factor for coronary heart disease. |
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