| Coronary Heart Disease(coronary heart disease, CHD) is very serious cardiovascular disease with high morbidity and mortality, threating the human,s health. Although the great progress has been made in modern medical diagnosis and treatment of coronary artery disease, the knowledge in etiology of coronary artery disease is still insufficient. Recent studies have shown that chronic inflammation is involved in the development of coronary heart disease. For example, the levels of high sensitivity C-reactive protein(hs-CRP), a inflammatory marker, and soluble vascular cell adhesion molecule vascular lesions-1(s VCAM-1) which could attract inflammatory cells in patients with coronary heart disease were significantly upregulated.Percutaneous coronary intervention therapy(PCI) is the primary treatment for CHD. However, stent implantation could lead to target vessel injury, the endothelial cell injury and inflammation in blood vessels were associated with increase of plasma hs-CRP and s VCAM-1, which could enhance inflammation.Thus, inflammatory reaction induced by stent implantation limited the application of PCI as it was involved in stent restenosis and a variety of acute and chronic complications, control of excessive inflammation is benefit for reducing the incidence of adverse cardiovascular events after PCI.Numerous studies have showed that micro RNAs are involved in physiological and pathological changes in the regulation of cardiovascular system.For example, micro RNA-126 could promote proliferation and repair of endothelial cells and suppress inflammation. Study on the correlation of micro RNAs with hs-CRP or VCAM-1 after PCI might reveal the mechanism of post PCI restenosis and provide thetargets for therapeutic intervention with practical significance.The purpose of this project is to test the levels of micro RNA-126 and hs-CRP,s VCAM-1 in patients with CHD before and after PCI. The correlation of mi RNA-126 with hs-CRP and s VCAM-1 may reveal the mechanism of post- PCI restenosis and provide the appropriate therapeutic targets.Subjects: We studied 74 patients with CHD and 48 patients admitted to the hospital because of chest pain and suspicion confirmed by coronary angiography from the Second Hospitalof Jilin University between October 2015 to December2015. CHD group is divided into acute coronary syndrome group(n=38) and stable angina group(n=36). Serum levels of hs-CRP and s VCAM-1 were tested using enzyme-linked immunosorbent assay(enzyme limked immuno assay,ELISA) in 5 minute before PCI and 30 minute, one day,three day after PCI, and the micro RNA-126 was tested by q PCR. In addition, the correlation of number of stents implanted, the number of balloon and balloon total pressure with serum hs-CRP, s VCAM-1 and micro RNA-126 were analyzed. Furthermore, we take a three-month follow-up observation of major adverse cardiac events(MACE)among the patients with PCI.Before PCI, plasma s VCAM-1, hs- CRP were significantly up-regulated in ACS PCI and SAP PCI groups, compared with the control group(P <0.05), while the mi R-126 was significantly down-regualted(P <0.05); plasma s VCAM-1, hs- CRP in ACS PCI group were significantly higher than that in SAP PCI group,(P <0.05), but there was no significancein mi R-126 between the ACSPCI and SAPPCI group(P>0.05).There was no significance of s VCAM-1, hs- CRP in ACS PCI and SAP PCI groups at 30 min post PCI(P> 0.05), but significantly increased(P <0.05) at postoperative 1d, 3d and reach to the highest content at 3d time; and plasma level of mi R-126 was significantly lower at 5min after PCI(P <0.05), and gradually lowered to the minimum at 3d after PCI; plasma s VCAM-1, hs-CRP, mi R-126 levels was not statistically significant in normal control group patients before and after PCI(p> 0.05).The plasma s VCAM-1 in ACS PCI and SAP PCI groups at 3d after PCI was positively correlated with the number of intraoperative balloon dilatation and the expansion of the total pressure(r=0.427, p<0.001; r=0.462, p<0.001, respectively); but the plasma mi R-126 in ACS PCI and SAP PCI groups at 3d after PCI was negatively correlated with the number of intraoperative balloon dilatation(r=-0.275, p<0.001).The plasma s VCAM-1 in ACS PCI and SAP PCI groups was positively correlated with hs-CRP(r=0.750, p<0.001), while negatively correlated with mi R-126(r=-0.275, p<0.001, r=-0.225, p<0.001).Conclusion:1、PCI up-reuglated the plasma level of inflammatory markers s VCAM-1,hs-CRP and there was a positive correlation of s VCAM-1 with balloon times and pressure.2、There was a negative correlation of plasma mi R-126 with s VCAM-1 and hs-CRP, indicating that mi R-126 may reduce the inflammatory response caused by PCI. |
PDF Full Text Request