摘要
目的 探究微小核糖核酸(miR)-5787、miR-146a及miR-133在经皮冠状动脉介入治疗(PCI)术后肺部感染患者中表达水平及其与机体炎症、凝血纤溶因子水平的关系.方法 将济南市第四人民医院2021年7月—2023年7月收治的131例冠心病PCI患者术后发生肺部感染和未发生肺部感染的患者分别纳入感染组(26例)和非感染组(105例);比较两组miR-5787、miR-146a、miR-133及机体炎症、凝血纤溶因子水平;采用Pearson分析miR-5787、miR-146a、miR-133与机体炎症、凝血纤溶因子的相关性;采用受试者工作特征曲线(ROC)分析miR-5787、miR-146a、miR-133对冠心病PCI患者术后肺部感染的诊断价值.结果 感染组血清miR-5787、miR-146a、miR-133、E选择素、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、C-反应蛋白(CRP)及血浆纤维蛋白原(FIB)、D-二聚体(D-D)、组织纤溶酶原抑制物(PAI)、血管性血友病因子(vWF)水平高于非感染组(P＜0.05),抗凝血酶-Ⅲ(AT-Ⅲ)水平低于非感染组(P＜0.05);miR-5787、miR-146a、miR-133 与 E 选择素、TNF-α、IL-6、CRP、FIB、D-D、PAI、vWF 水平呈正相关(P＜0.05),与 AT-Ⅲ 水平呈负相关(P＜0.05);miR-5787、miR-146a、miR-133联合检测诊断冠心病PCI患者术后肺部感染曲线下面积(AUC)值高于各项单一检测(P＜0.05),且联合检测敏感度为96.15％,特异度为80.00％.结论 冠心病PCI术后肺部感染患者miR-5787、miR-146a、miR-133、机体炎症、凝血纤溶系统表达异常;miR-5787、miR-146a、miR-133与机体炎症、凝血纤溶因子有相关性,且三者联合检测可提高冠心病PCI患者术后肺部感染的诊断价值.
Abstract
OBJECTIVE To investigate the expression levels of microRNA(miR)-5787,miR-146a and miR-133 in patients with pulmonary infection after percutaneous coronary intervention(PCI)and their relationship with the factors related to body inflammation,coagulation and fibrinolysis.METHODS A total of 131 patients with coro-nary heart disease undergoing PCI admitted to the Fourth People's Hospital of Jinan from Jul 2021 to Jul 2023 were divided into the infected group(26 cases)and non-infected group(105 cases).The levels of miR-5787,miR-146a,miR-133 and factors related to inflammatory,coagulation and fibrinolysis were compared between the two groups.Pearson analysis was used to analyze the correlation of miR-5787,miR-146a and miR-133 with factors in inflammation,coagulation and fibrinolysis.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of miR-5787,miR-146a and miR-133 in pulmonary infection in patients with coronary heart disease after PCI.RESULTS The serum levels of miR-5787,miR-146a,miR-133,E-selectin,tumor necrosis fac-tor(TNF)-a,interleukin(IL)-6 and C-reactive protein(CRP),the levels of plasma fibrinogen(FIB),D-dimer(D-D),plasminogenemia activator inhibitor(PAI),von Willebrand factor(vWF),were higher than those in the non-infected group(P＜0.05),and antithrombin-Ⅲ(AT-Ⅲ)were lower than those in the non-infected group(P＜0.05).The miR-5787,miR-146a and miR-133 levels were positively correlated with E-selectin,TNF-α,IL-6,CRP,FIB,D-D,PAI and vWF levels(P＜0.05),and negative correlation with the level of AT-Ⅲ(P＜0.05).The area under the curve(AUC)value of combined detection of miR-5787,miR-146a and miR-133 in the diagnosis of pulmonary infection in patients with coronary heart disease after PCI was higher than that of single de-tection(P＜0.05);and the sensitivity and specificity of combined detection was 96.15％and 80.00％,respectov-ely.CONCLUSION The expression of miR-5787,miR-146a,miR-133,body inflammation,and factors related to coagulation and fibrinolysis system were abnormal in patients with coronary heart disease and postoperative pul-monary infection after PCI.The miR-5787,miR-146a,and miR-133 were correlated with the levels of inflamma-tion,coagulation and fibrinolysis factors.The combined detection of the three indexes can improve the diagnostic value of pulmonary infection in patients with coronary heart disease after PCI.
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