司东雷,李静,李文洪,董丽娟,王玮娜,胡杰,赵梦鸥,王书行
SI Donglei,LI Jing,LI Wenhong,DONG Lijuan,WANG Weina,HU Jie,ZHAO Mengou,WANG Shuhang

• 1:河北医科大学附属石家庄第三医院CT/MRI科
• 2:邯郸市第二医院心内二科
• 3:河北医科大学附属石家庄第三医院医保科

摘要(Abstract)：

目的 探讨微小RNA-29b(miR-29b)及炎症因子水平与冠状动脉成像（CTA）钙化积分（CACS）的关系。方法 60例冠状动脉造影诊断为冠心病的患者为观察组，同期60例冠状动脉造影正常者为对照组，观察组患者根据CACS分为轻度钙化组（n=13）、中度钙化组（n=27）及重度钙化组（n=20）；比较观察组与对照组、不同钙化组被检者性别、年龄、体质量指数（BMI）、高血压史、糖尿病史、吸烟史、饮酒史，检测血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、C反应蛋白（CRP）、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、miR-29b水平，分析miR-29b、CRP、IL-6、IL-10与CACS的相关性。结果 观察组与对照组患者性别、年龄、BMI、高血压史、糖尿病史、吸烟史、饮酒史比较差异无统计学意义（P> 0.05）；观察组血清TC、TG、LDL-C、CRP、IL-6、IL-10水平显著高于对照组，HDL-C、miR-29b水平显著低于对照组（P<0.05）；不同钙化组患者性别、年龄、BMI、高血压史、糖尿病史、吸烟史、饮酒史及血清TC、TG、LDL-C、HDL-C水平比较，差异无统计学意义（P> 0.05）；随着患者狭窄冠状动脉的钙化程度加重，血清miR-29b水平逐渐降低，血清CRP、IL-6、IL-10水平逐渐升高，各钙化组间比较差异有统计学意义（P<0.05）；回归分析显示，血清miR-29b(OR=1.392,95%CI为1.207～2.004)、CRP(OR=1.701,95%CI为1.039～2.897)、IL-6(OR=1.218,95%CI为1.114～1.385)及IL-10(OR=1.714,95%CI为1.197～2.215)是冠心病患者重度钙化的危险因素（P<0.05）；相关性分析显示，血清miR-29b水平与CACS呈负相关（r=-0.583,P<0.001），血清CRP、IL-6、IL-10与CACS呈正相关（r=0.677、0.641、0.496,P<0.001）。结论 miR-29b及炎症因子水平与CACS具有一定相关性，对冠心病的钙化程度及病情评估具有一定参考价值。
Objective To explore the association of microRNA-29b(miR-29b) and inflammatory factor levels with coronary CT angiography(CTA) and calcification score(CACS).Methods Sixty patients with coronary heart disease diagnosed by coronary angiography were recruited as observation group, and 60 persons with normal coronary angiography in the same period were included in control group. The patients in observation group were divided into mild calcification(n= 13), moderate calcification(n= 27) and severe calcification subgroups(n = 20) according to CACS. Gender, age,body mass index(BMI), hypertension history, diabetes history, smoking history and drinking history were compared among control group, observation group and three subgroups. Serum total cholesterol(TC), triglyceride( TG), low density lipoprotein cholesterol( LDL-C), high density lipoprotein cholesterol(HDL-C), C-reactive protein(CRP), interleukin-6(IL-6), IL-10, andmiR-29blevel were detected. The associations ofmiR-29b, CRP, IL-6, and IL-10 with CACS were analyzed.Results There were no significant differences in gender, age, BMI, history of hypertension, history of diabetes, history of smoking, and history of drinking between observation and control groups(P>0. 05). The levels of serum TC, TG, LDL-C, CRP, IL-6, and IL-10 were significantly higher in observation group than those in control group, while the levels of HDL-C andmiR-29bwere significantly lower observation group than those in control group(P< 0. 05). There were no significant differences in gender, age, BMI, history of hypertension, history of diabetes, history of smoking,history of drinking, and serum TC, TG, LDL-C, and HDL-C levels of patients in different calcification subgroups(P> 0. 05). With CACS aggravation, serummiR-29bwas gradually decreased, while the levels of serum CRP, IL-6, and IL-10 were gradually increased among calcification subgroups(P<0. 05). Regression analysis showed that serummiR-29b(OR= 1. 392, 95%CIwas 1. 207-2. 004),CRP(OR= 1. 701, 95%CIwas 1. 039-2. 897), IL-6(OR= 1. 218, 95%CIwas 1. 114-1. 385), and IL-10(OR= 1. 714, 95%CIwas 1. 197-2. 215) were risk factors for severe calcification in patients with coronary heart disease(P< 0. 05). Correlation analysis revealed that serummiR-29bwas negatively correlated with CACS(r=-0. 583,P< 0. 001), while serum CRP, IL-6, and IL-10 were positively correlated with CACS(r= 0. 677, 0. 641, 0. 496;P< 0. 001).Conclusion The levels of miR-29band inflammatory factors correlate with CACS, also has certain reference value for the calcification degree of coronary heart disease and the evaluation of its condition.

关键词(KeyWords)： 微小RNA-29b;C反应蛋白;白细胞介素-6;白细胞介素-10;冠状动脉成像;钙化积分
microRNA-29b;C-reactive protein (CRP);interleukin-6 (IL-6);interleukin-10 (IL-10);coronary CT angiography (CTA);calcification score (CACS)

Abstract:

Keywords:

基金项目(Foundation): 河北省卫生厅科技计划项目（20181662）;; 石家庄市科学技术研究与发展指导计划项目（161462413）

作者(Author): 司东雷,李静,李文洪,董丽娟,王玮娜,胡杰,赵梦鸥,王书行
SI Donglei,LI Jing,LI Wenhong,DONG Lijuan,WANG Weina,HU Jie,ZHAO Mengou,WANG Shuhang

DOI: 10.19367/j.cnki.2096-8388.2022.06.017

参考文献(References)：

• [1] SIFRI S A, SHAMMERI O A, JASER S A, et al. Prevalence of lipid abnormalities and cholesterol target value attainment in patients with stable coronary heart disease or an acute coronary syndrome in Saudi Arabia[J]. Saudi Med J, 2018, 39(7):697-704.
• [2] NAKAO Y M, MIYAMOTO Y, HIGASHI M, et al. Sex differences in impact of coronary artery calcification to predict coronary artery disease[J]. Heart, 2018, 104(13):1118-1124.
• [3] OTRI M, KUKULJAN M, MARKI D, et al. Expression of bone-related proteins in vascular calcification and its serum correlations with coronary artery calcification score.[J]. J Biol Reg Homeos Ag, 2019, 33(1):29-38.
• [4] GLAUCYLARA G, PETER L. Atherosclerosis and inflammation:overview and updates[J]. Clin Sci, 2018,132(12):1243-1252.
• [5]中华医学会心血管病学分会介入心脏病学组，中华医学会心血管病学分会动脉粥样硬化与冠心病学组，中国医师协会心血管内科医师分会血栓防治专业委员会，等．稳定性冠心病诊断与治疗指南[J]．中华心血管病杂志，2018, 46(9):680-694.
• [6]《中国高血压防治指南》修订委员会．中国高血压防治指南2018年修订版[J]．心脑血管病防治，2019, 19(1):1-44.
• [7]中华医学会糖尿病学分会．中国2型糖尿病防治指南（2017年版）[J]．中国实用内科杂志，2018, 38(4):292-344.
• [8] MORI H, TORII S, KUTYNA M, et al. Coronary artery calcification anditsprogression:what does it really mean[J]. Jacc-Cardiovasc Imag,2018,11(1):127.
• [9] LEMOS P G, PEREIRA S, SOUTO N M, et al. Detection of coronary artery calcification with nontriggered computed tomography of the chest[J]. Radiologia Brasileira,2018, 51(1):8-12.
• [10]中华预防医学会，中华预防医学会心脏病预防与控制专业委员会，中华医学会糖尿病学分会，等．中国健康生活方式预防心血管代谢疾病指南[J]．中华预防医学杂志，2020, 54(3):256-277.
• [11] ROMEO-GABRIEL M. Pragmatic analysis of dyslipidemia involvement in coronary artery disease:a narrative review[J]. Curr Cardiol Rev, 2020, 16(1):36-47.
• [12]蔡珠虹，刘天佳，赵静，等．颈动脉斑块易损性与血脂指标，炎症因子和冠心病的关系[J]．现代生物医学进展，2019, 19(4):71-74.
• [13]YILMAZ S G, ISBIR S, KUNT A T, et al. Circulating microRNAs as novel biomarkers for atherosclerosis[J].In Vivo, 2018, 32(3):561-565.
• [14]翟科峰，段红，李洁，等．涉及脂质代谢的miRNA及其对动脉粥样硬化发展和治疗的进展[J]．基因组学与应用生物学，2018, 37(12):494-500.
• [15]刘善宽，尹俊明．PCT、CRP、血清胆红素、尿酸及载脂蛋白A1、 B对冠心病的诊断价值[J]．广东医学，2019, 40(15):2246-2248.
• [16]罗建华，王超．血栓通对老年冠心病介入术后患者血清炎症因子和血液流变学指标的影响[J]．中国老年学杂志，2018, 38(14):3358-3360.
• [17]殷娟，姬超，尚晓娜，等．心脏介入手术对冠心病患者外周血hsCRP、IL-4及IL-10水平的影响[J]．心血管康复医学杂志，2018, 27(4):417-420.
• [18]齐德林，李洪利，李杨，等．血浆miR-29b与急性冠脉综合征患者胞外基质蛋白含量的关系及其诊断价值分析[J]．现代生物医学进展，2020, 20(10):1850-1853.
• [19]彭春丽，梁东辉，黄曾艳，等．冠心病患者血瘀证积分联合超敏C反应蛋白对动脉粥样硬化斑块性质的初步评价[J]．广东医学，2018, 39(1):143-147.
• [20]吴军，文亚红，唐永江．冠心病合并糖尿病患者PCI术后TLR3,TLR4,IL-10,TNF-α的表达变化及意义[J]．中国循证心血管医学杂志，2018, 10(4):493-497.

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