| Background:Since Academician Chen Keji first advocated the blood circulation therapy of coronary heart disease,activating blood circulation therapy significantly improvedthe efficacy of traditional Chinese Medicine treatment ofcardiovascular diseases.Activating blood circulation drugs include the harmonizing blood medicines, medicines ofinvigoratingbloodcirculation and stasis-breaking drugs.In less severe cases of blood stasis patients using the expelling blood drugswill injury blood. In severe cases, only using the blood-harmonizing drugs cannot remove stasis well.Therefore,when using the activating blood circulation medicine,we should identify the severity of blood stasis syndrome(BSS).But the traditional theoretical knowledge and personal experience havea certain subjectivity,affecting the treatment efficacy.Acute coronary syndrome (ACS) is a severe type of coronary heart disease.Previous studies suggested that the heavier the degree of blood stasis is, the higher the risk of recurrence of cardiovascular events.MicroRNAas part of the functional genomics in systems biology, has many characteristics, such as timeliness, holism concept,which are the same with the overall concept of Traditional Chinese Medicine.Team earlier study has shown that blood stasis syndrome exists the differential expressionof microRNAs comparing with non-blood stasis syndrome.So further studying the role of circulating microRNAin discriminating the severity and prognostic assessment in ACS, to identify new diagnostic and prognostic evaluation indexes of important clinical significance.Objective:1Tolookfor the objective indicators that can provide an objective basis for the discriminationofthe severity of blood stasis syndrome;2 To study the role of circulating microRNAs in discriminating the severity and prognostic assessment in ACS, to identify new diagnostic and prognostic evaluation index.Methods:1 The ACS patients with mildor severeblood stasis syndrome were recruited as objects of this study, with healthy volunteerssaving as the control. The differences of WBC,PLT,lipids(TC,TG,HDL-C,LDL-C), coagulation (Fbg, D-Di,FDP), inflammatory cytokines (hsCRP, HCY), Tnl, BNP, the rate of platelet inhibition, platelet aggregation rate, the severity of coronary lesions and so on were compared between the mildand severeblood stasis syndromegroups,to provide an objective basis for the severity;2.Usefluorescent quantitationPCR technology,to find whether the expression of four kinds of microRNA (miR-208a-3p, miR-222-3p,miR-16, miR-198)has difference,and making correlation analysis between the score of blood stasis andthe expression of four kinds of microRNA.3.Compare the difference between the two groups of patientsin GRACE scores,GRACE risk stratificationand the occurrence of MACE events.At the same time, correlation analysis was performed between the score of blood stasis syndrome and GRACE scores.4.Making correlation analysis betweenGRACE scores andthe expression of four kinds of microRNA.Results:1.Comparing to the healthy volunteers, the platelet counts of mild and severeblood stasis syndrome patients reduced (p<0.05), no statistically significant difference between mild and severe syndrome patients (p> 0.05); The TC and HDL-C ofsevere syndrome patientsreduced compared with healthy volunteers (p<0.05), andthere was nosignificant difference between mild blood stasis syndrome and thehealthy volunteers (p> 0.05)), no significant difference in the severity of blood stasis Syndrome as well (p> 0.05); TGincreased in two groups of patients compared with healthy volunteers,while LDL-C reduced (p< 0.05).There is no significant difference between blood stasis syndrome of mild and severe type inTG and LDL-C (p> 0.05).2.The relative expression of miR-222-3p in mild stasis syndrome down-regulated compared with healthy volunteers.In the relative expression of miR-198,mildstasis syndrome upregulatedcompared withthe healthy volunteers,no significant difference between severe syndrome patients andhealthy volunteers,severe syndrome patientsdecreased than mildstasis syndrome patients.Compared with healthy volunteers, miR-208a-3p in blood stasis syndrome groupsare significantly increased.But the mild and severe groups have no significant difference. There is no significant correlation between 4 kinds of microRNA expression and blood stasis scores.3.Two groups of patients have no significant difference in the GRACE prediction calculus and the occurrence of MACE. However,there issignificant difference between two groups of patientsat 6 months of all-cause mortality GRACE risk stratification.Mild blood stasis syndrome group has the highest proportion of low-risk for 80.65%.Severe blood stasis syndrome group have lowand moderate-risk proportion respectively 51.72% and 44.83%.Thescore of blood stasis with the GRACE scores in the hospital all-cause mortality and all-cause mortality 6 months are relevant.The correlation coefficients are 0.31,0.33,0.24 respectively (p<0.05).4.There is no significant correlation between 4 kinds of microRNA expression and GRACE scores.Conclusions:1.High-density lipoprotein can distinguish the severity of blood stasis syndrome.Severe blood stasis syndrome patients than healthy volunteers decrease.2.MiR-222-3p and miR-198 can help to distinguish the severity of blood stasis syndrome. The relativeexpression of miR-222-3p declinesin mildblood stasis syndrome patients than in healthy volunteers. The relative expression of miR-198 upregulates only in mildblood stasis patients.MiR-208a-3p can be used as the distinction between blood stasis and healthy volunteers.The expression of miR-208a-3p in blood stasispatients up-regulates.There is no significant correlation between 4 kinds of microRNA expression and blood stasis score.3.There is difference at 6 months of all-cause mortality GRACE risk stratification.The heavier the blood stasis is, the worse the prognosis is. With the score of blood stasisincreasing, the GRACE score of in the hospital all-cause mortality and all-cause mortality 6 months increase.4.The relative expression of the 4 kinds ofmicroRNAsalone is not enough to assess the patients’ prognosis. |
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