临床内科杂志 ›› 2020, Vol. 37 ›› Issue (1): 28-31.doi: 10.3969/j.issn.1001-9057.2020.01.009

• 论 著 • 上一篇    下一篇

血小板微小RNA-223和微小RNA-21对冠心病患者经皮冠状动脉介入治疗后氯吡格雷抵抗的预测价值

  

  • 出版日期:2020-01-15 发布日期:2020-01-15
  • 基金资助:
    河南省医学科技攻关计划项目(201602330)

Predictive value of platelet microRNA-223 and microRNA-21 on clopidogrel resistance after percutaneous coronary intervention in patients with coronary heart disease

  • Online:2020-01-15 Published:2020-01-15

摘要: 目的 探讨血小板微小RNA(miR)-223和miR-21对冠心病患者经皮冠状动脉介入治疗(PCI)后氯吡格雷抵抗的预测价值。方法 根据血小板抑制率,将119例行PCI的冠心病患者分为氯吡格雷反应正常组(正常组)67例和氯吡格雷抵抗组(抵抗组)52例。比较两组患者的血小板miR-23和miR-21水平。采用多元logistic回归分析评估发生氯吡格雷抵抗的影响因素。采用Pearson相关分析评估血小板miR-223、miR-21水平与血小板抑制率的相关性。采用受试者工作特征(ROC)曲线评估血小板miR-223和miR-21水平对发生氯吡格雷抵抗的预测价值。结果 抵抗组患者血小板miR-223和miR-21水平高于正常组(P<0.05)。多元logistic回归分析结果显示,血小板miR-223和miR-21水平升高是冠心病患者PCI后发生氯吡格雷抵抗的独立危险因素(P<0.05)。Pearson相关分析结果显示,行PCI的冠心病患者血小板miR-223和miR-21水平与血小板抑制率均呈负相关(P<0.05)。血小板miR-223和miR-21预测冠心病患者PCI后发生氯吡格雷抵抗的ROC曲线下面积(AUC)分别为0.69(95%CI 0.53~0.78)、0.64(95%CI 0.51~0.69);血小板miR-223联合miR-21的AUC为0.85(95%CI 0.77~0.94)。结论 PCI后发生氯吡格雷抵抗的冠心病患者血小板miR-223和miR-21水平升高,且与血小板抑制率呈负相关,可用于预测氯吡格雷抵抗的发生风险。

关键词: 氯吡格雷抵抗; 冠心病; 微小RNA-223; 微小RNA-21

Abstract: Objective To explore the predictive value of platelet microRNA(miR)-223 and miR-21 on clopidogrel resistance after percutaneous coronary intervention(PCI) in patients with coronary heart disease(CHD).Methods According to platelet inhibition rate,119 patients with CHD undergoing PCI were divided into normal clopidogrel response(normal group,67 cases) and clopidogrel resistance group(resistance group,52 cases).Levels of platelet miR-23 and miR-21 were compared between the two groups.Multivariate logistic regression analysis was used to assess the influencing factors of clopidogrel resistance.Pearson correlation analysis was used to evaluate correlation between levels of platelet miR-223 and miR-21 with platelet inhibition rate.Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of platelet miR-223 and miR-21 for clopidogrel resistance.Results Levels of platelet miR-223 and miR-21 in resistance group were higher than those in normal group(P<0.05).Results of multivariate logistic regression analysis showed that increased levels of platelet miR-223 and miR-21 were independent risk factors for clopidogrel resistance after PCI in patients with CHD(P<0.05).Results of Pearson correlation analysis showed that levels of platelet miR-223 and miR-21 were negatively correlated with platelet inhibition rate in patients with CHD undergoing PCI(P<0.05).Area under ROC curve(AUC) of platelet miR-223 and miR-21 predicting clopidogrel resistance after PCI in patients with CHD were 0.69(95%CI 0.53~0.78),0.64(95%CI 0.51~0.69) respectively,and AUC of platelet miR-223 combined with miR-21 was 0.85(95%CI 0.77~0.94).ConclusionLevels of platelet miR-223 and miR-21 in patients with CHD who develop clopidogrel resistance after PCI increase,and they are negatively correlated with platelet inhibition rate,which can be used to predict the risk of clopidogrel resistance.

Key words: Clopidogrel resistance; Coronary heart disease; MicroRNA-223; MicroRNA-21