急性冠状动脉综合征患者早期冠状动脉病变的评估

赵娟; 涂腾灿; 杨梅君; 张小勇; 潘伟

doi:10.12259/j.issn.2095-610X.S20211219

急性冠状动脉综合征患者早期冠状动脉病变的评估

doi: 10.12259/j.issn.2095-610X.S20211219

赵娟¹,
涂腾灿²,
杨梅君³,
张小勇^4, ,,
潘伟^2, ,

1.
华南理工大学附属第六医院/南海区人民医院超声科
2.
心内科，广东佛山　528200
3.
临沧市人民医院药剂科，云南临沧　677000
4.
昆明医科大学附属延安医院心内科，云南昆明　650051

基金项目: 广东省自然科学基金资助项目（2015A030310068）；佛山市医学科技攻关基金资助项目（2020001004341）；佛山市杰出青年医学人才计划基金资助项目（201803）

详细信息

作者简介:
赵娟（1979～）女，湖北黄梅人，医学学士，副主任医师，主要从事心脏超声诊断工作

通讯作者:
张小勇，E-mail：zhangxykm@sohu.com

潘伟，E-mail：weipan1977@163.com

中图分类号: R543.3
计量
- 文章访问数: 3861
- HTML全文浏览量: 2337
- PDF下载量: 24
- 被引次数: 0
出版历程
- 收稿日期: 2021-09-05
- 网络出版日期: 2021-11-17
- 刊出日期: 2021-12-15

Assessment of Early Coronary Artery Disease in Patients with Acute Coronary Syndrome

1.
Dept. of Ultrasound
2.
Dept. of Cardiovascular，The 6th Affiliated Hospital，South China University of Technology，Nanhai People Hospital，Foshan Guangdong 528200
3.
Dept. of Pharmacy，Lincang People’s Hospital，Lincang Yunnan 677000
4.
Dept. of Cardiovascular，The Affiliated Yan’an Hospital of Kunming Medical University，Kunming Yunnan 650051，China

摘要

摘要: 目的探讨血浆miR-30a与冠状动脉血管内超声（IVUS）在急性冠状动脉综合征（ACS）患者早期冠状动脉病变评估中的作用。方法随机入选88例ACS患者，包括稳定性心绞痛组（SA组，42例）和ACS组（46例）。用IVUS检测斑块负荷和重构指数（RI），用Real-time PCR法检测血浆miR-30a的含量。研究ACS组斑块负荷、RI和血浆miR-30a的变化。用Pearson相关性分析斑块负荷、血浆miR-30a和RI的关系。结果与SA组比较，ACS组患者斑块负荷增加[（62.82±4.40）%比（68.32±4.59）%]；RI增加（0.90±0.03）比（1.15±0.05）；血浆miR-30a升高[（8.10±1.09）2^-ΔΔct*10⁴比（11.66±1.19）2^-ΔΔct*10⁴]（P < 0.05）。RI和斑块负荷（r = 0.482，P = 0.000）、血浆miR-30a水平（r = 0.817，P = 0.000）呈正相关。结论 ACS患者早期已发生冠状动脉正性重构，血浆miR-30a可以作为ACS早期冠状动脉病变的评估指标。
- 超声心动图 /
- 微RNAs /
- 急性冠状动脉综合征 /
- 血管重构
Abstract: Objective To investigate the role of plasma miR-30a and coronary intravascular ultrasound （IVUS） in the early assessment of coronary artery disease in patients with acute coronary syndrome （ACS）. Methods 88 ACS patients were randomly selected, including stable angina group （SA group, 42 cases） and ACS group （46 cases）. Plaque load and remodeling index （RI） were detected by IVUS, and plasma miR-30a was detected by real-time PCR. The changes of plaque load, RI and plasma miR-30a in ACS group were studied. The relationship between plaque load, plasma miR-30a and RI was analyzed by Pearson correlation. Plaque load and remodeling index （RI） were detected by IVUS, and plasma miR-30a was detected by real-time PCR. The changes of plaque load, RI and plasma miR-30a in ACS group were studied. The relationship between plaque load, plasma miR-30a and RI was analyzed by Pearson correlation. Results Compared with SA group, plaque load in ACS group was increased [ （62.82±4.40）% vs （68.32±4.59）%]; RI increased from （0.90±0.03） to （1.15±0.05）; plasma miR-30a[ （8.10±1.09）2^-ΔΔct*10⁴ vs （11.66±1.19）2^-ΔΔct*10⁴] increased. RI was positively correlated with plaque load （r = 0.482, P = 0.000） and plasma miR-30a level （r = 0.817, P = 0.000）. Conclusion Patients with ACS have early coronary artery positive remodeling, and plasma miR-30a can be used as an evaluation indicator of early ACS coronary artery disease.
- Echocardiography /
- microRNAs /
- Acute coronary syndrome /
- Vascular remodeling

HTML全文

图 1 斑块负荷与RI的相关性分析

Figure 1. Correlation of plaque load with RI

下载: 全尺寸图片幻灯片

图 2 血浆miR-30a与RI的相关性分析

Figure 2. Correlation of plasma miR-30a with RI

下载: 全尺寸图片幻灯片

表 1 2组临床基础资料（$ \bar x \pm s $）

Table 1. Clinical information of the patients （$ \bar x \pm s $）

组别	n	年龄（岁）	性别（男/女）	收缩压（mmHg）	舒张压（mmHg）	空腹血糖（mmol/L）	LDL-C （mmol/L）	血肌酐（μmol/L）
SA组	42	62.2 ± 12.4	22/20	126.8 ± 18.1	70.9 ± 11.3	5.2 ± 0.8	2.9 ± 0.5	81.2 ± 16.1
ACS组	46	63.1 ± 9.9^*	24/22^*	127.6 ± 20.6^*	72.6 ± 10.9^*	5.2 ± 1.0^*	2.7 ± 0.6^*	79.8 ± 15.3^*
与SA组相比，^*P > 0.05。

下载: 导出CSV

表 2 2组患者斑块负荷、RI和血浆miR-30a比较（$ \bar x \pm s $）

Table 2. Comparison of plaque load，RI and plasma miR-30a in 2 groups （$ \bar x \pm s $）

组别	n	斑块负荷（%）	RI	血浆miR-30a（2^−ΔΔct*10⁴）
SA组	42	62.82 ± 4.40	0.90 ± 0.03	8.10 ± 1.09
ACS组	46	68.32 ± 4.59^*	1.15 ± 0.05^*	11.66 ± 1.19^*
与SA组相比，^*P < 0.05。

下载: 导出CSV

参考文献(16)

[1]	Libby P,Pasterkamp G,Crea F,et al. Reassessing the mechanisms of acute coronary syndromes[J]. Circ Res,2019,124(1):150-160. doi: 10.1161/CIRCRESAHA.118.311098
[2]	Kimura S,Sugiyama T,Hishikari K,et al. The clinical significance of echo-attenuated plaque in stable angina pectoris compared with acute coronary syndromes:A combined intravascular ultrasound and optical coherence tomography study[J]. Int J Cardiol,2018,270(1):1-6.
[3]	Stone G W,Maehara A,Ali Z A,et al. Percutaneous coronary intervention for vulnerable coronary atherosclerotic plaque[J]. J Am Coll Cardiol,2020,76(20):2289-2301. doi: 10.1016/j.jacc.2020.09.547
[4]	Yang X,Gai LY,Li P,et al. Diagnostic accuracy of dual-source CT angiography and coronary risk stratification[J]. Vasc Health Risk Manag,2010,6:935-941.
[5]	Andrews J,Puri R,Kataoka Y,et al. Therapeutic modulation of the natural history of coronary atherosclerosis:Lessons learned from serial imaging studies[J]. Cardiovasc Diagn Ther,2016,6(4):282-303. doi: 10.21037/cdt.2015.10.02
[6]	Maehara A,Matsumura M,Ali ZA,et al. IVUS-guided versus OCT-guided coronary stent implantation:A critical appraisal[J]. JACC Cardiovasc Imaging,2017,10(12):1487-1503. doi: 10.1016/j.jcmg.2017.09.008
[7]	Ono M,Kawashima H,Hara H,et al. Advances in IVUS/OCT and future clinical perspective of novel hybrid catheter system in coronary imaging[J]. Front Cardiovasc Med,2020,7:119. doi: 10.3389/fcvm.2020.00119
[8]	Nguyen P,Seto A. Contemporary practices using intravascular imaging guidance with IVUS or OCT to optimize percutaneous coronary intervention[J]. Expert Rev Cardiovasc Ther,2020,18(2):103-115. doi: 10.1080/14779072.2020.1732207
[9]	Reddy S,Kadiyala V,Kashyap J R,et al. Comparison of intravascular ultrasound virtual histology parameters in diabetes versus Non-diabetes with acute coronary syndrome[J]. Cardiology,2020,145(9):570-577. doi: 10.1159/000508886
[10]	Marino B C A,Buljubasic N,Akkerhuis M,et al. Adiponectin in relation to coronary plaque characteristics on radiofrequency intravascular ultrasound and cardiovascular outcome[J]. Arq Bras Cardiol,2018,111(3):345-353.
[11]	Kochergin N A,Kochergina A M,Khorlampenko A A,et al. Vulnerable atherosclerotic plaques of coronary arteries in patients with stable coronary artery disease:12-months follow-up[J]. Kardiologiia,2019,60(2):69-74.
[12]	Çoner A,Aydınalp A,Müderrisoğlu H. Evaluation of hs-CRP and sLOX-1 levels in moderate-to-high risk acute coronary syndromes[J]. Endocr Metab Immune Disord Drug Targets,2020,20(1):96-103. doi: 10.2174/1871530319666190408145905
[13]	Tateishi K,Kitahara H,Saito Y,et al. Impact of clinical presentations on lipid core plaque assessed by near-infrared spectroscopy intravascular ultrasound[J]. Int J Cardiovasc Imaging,2021,37(4):1151-1158. doi: 10.1007/s10554-020-02107-w
[14]	Merkulova I N,Shariya M A,Mironov V M,et al. Computed tomography coronary angiography possibilities in "High Risk" plaque identification in patients with non-ST-elevation acute coronary syndrome:Comparison with intravascular ultrasound[J]. Kardiologiia,2021,60(12):64-75. doi: 10.18087/cardio.2020.12.n1304
[15]	Wei Pan,Yun Zhong,Chuanfang Cheng,et al. miR-30-Regulated autophagy mediates angiotensin II-induced myocardial hypertrophy[J]. PLoS ONE,2013,8(1):53950. doi: 10.1371/journal.pone.0053950
[16]	潘伟,赵娟,罗韶金,等. MiR-30a在血管紧张素Ⅱ诱导的心肌肥厚中的作用[J]. 中国心血管病研究,2016,14(6):567-571.

相关文章(20)

[1]	陈雪梅, 郭品, 钏刘芳, 王梓, 李雪娇, 何文姬. 基于Tei指数评价蒽环类药物对急性白血病患儿心脏毒性的研究, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240216
[2]	宋文娟, 马雪娟, 孙钺, 谷颖, 叶雨佳, 李姝墨, 葛菲, 刘利萍, 赵月, 王钰. 超声心动图三维斑点追踪技术对乳腺癌曲妥珠单抗治疗中心脏毒性评估的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230217
[3]	潘水水, 白劲松, 李重熙, 艾志琼, 田波, 母昌垒, 刘怡涵, 刘俊. HIV/AIDS患者超声心动图异常的影响因素分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230422
[4]	他林昆, 黄燕玲, 张静秋, 陆永萍. 超声心动图不同切面诊断胎儿先天性血管环的价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220615
[5]	马葳, 李梅华, 汤晓静, 任朝凤, 杨艳霞, 司恩杰, 黄倩, 曾小艺. 慢阻肺患者HRCT检查肺动脉直径与超声心动图检查肺动脉压的相关性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210643
[6]	他林昆, 黄燕玲, 陆永萍. 超声心动图诊断胎儿法洛四联症的价值, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210126
[7]	魏骊铮, 闵杰青, 田锦润, 曹彦洁, 潘鹏, 王鹏, 杨云娟, 罗云娇. 云南省婴幼儿不完全性川崎病急性期超声心动图特征, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210923
[8]	陈志松, 何彪华, 曾永利, 喻卓. 经胸超声心动图指引下儿童漏斗型动脉导管未闭封堵术临床应用, 昆明医科大学学报.
[9]	闵杰青, 田锦润, 洪伟, 魏骊铮, 曹彦洁, 王华平. 超声心动图对儿童漏斗胸手术右心室随访评价, 昆明医科大学学报.
[10]	叶学群, 聂磊. 超声心动图结合动态心电图诊断冠心病合并心力衰竭的价值, 昆明医科大学学报.
[11]	罗庆祎. 单心动周期实时三维超声心动图对房间隔缺损患者右心室功能的研究, 昆明医科大学学报.
[12]	龙琼华. 2型糖尿病对老年高血压患者颈动脉内膜中层厚度与左心室质量指数的影响及相关性, 昆明医科大学学报.
[13]	宋文娟. Tei指数对HIV感染/AIDS患者右室功能的评价, 昆明医科大学学报.
[14]	闵杰青. 昆明地区1 185例正常儿童冠状动脉内径的超声测量与分析, 昆明医科大学学报.
[15]	闵杰青. 彩色超声多普勒诊断小儿细小冠状动脉肺动脉瘘, 昆明医科大学学报.
[16]	陈丽星. 血管紧张素-(1-7)对野百合碱诱导的肺动脉高压及右心室重构的影响, 昆明医科大学学报.
[17]	张瑜. 经食管实时三维超声心动图在主动脉瓣置换术中的应用, 昆明医科大学学报.
[18]	贺光林. 心肌重构水平监测在慢性心衰患者病情评估中的临床意义, 昆明医科大学学报.
[19]	. 二维应变超声心动图对评价2型糖尿病患者左心室纵向收缩功能的作用, 昆明医科大学学报.
[20]	李华萍. 成人心肌致密化不全15例临床分析, 昆明医科大学学报.