目的:探讨稳定型心绞痛(SAP)患者循环微小 RNA(miR)-92a 表达水平与糖尿病及他汀类药物治疗的关系。方法选取2010年3月—2011年3月在广西壮族自治区人民医院心内科住院的 SAP 患者116例,其中合并糖尿病者30例,接受他汀类药物治疗者46例。采用 RT - qPCR 检测患者循环miR-92a表达水平。比较是否合并糖尿病及他汀类药物治疗对 SAP 患者循环miR-92a表达水平的影响;以及是否接受他汀类药物治疗对老年 SAP 患者循环miR-92a表达水平的影响。结果 SAP 患者循环miR-92a表达水平为(0.53±0.44),Pearson 相关分析结果显示,SAP 患者年龄与循环miR-92a表达水平呈正相关(r =0.217,P =0.019)。以循环miR-92a为因变量,年龄为协变量,协方差分析结果显示,糖尿病与年龄对循环miR-92a表达水平的影响存在交互作用(F =19.631,P ﹤0.05);他汀类药物治疗与年龄对循环miR-92a表达水平的影响存在交互作用(F =2.346,P ﹤0.05)。多因素方差分析结果显示,老年合并糖尿病接受他汀类药物治疗的 SAP 患者循环miR-92a表达水平低于未接受他汀类药物治疗的 SAP 患者( F =22.080,P=0.001);老年未合并糖尿病的 SAP 患者,是否接受他汀类药物治疗者循环miR-92a表达水平比较,差异无统计学意义(F ﹤0.001,P =0.992)。结论糖尿病及他汀类药物治疗对 SAP 患者循环miR-92a表达水平存在影响,且他汀类药物治疗使老年合并糖尿病 SAP 患者循环miR-92a表达水平降低,提示他汀类药物可能通过调控循环miR-92a表达水平进而起到改善内皮功能的作用。
Objective To investigate the relationship among expression level of circulating microRNA - 92a (miR-92a),diabetes and statin therapy in patients with stable angina pectoris(SAP). Methods 116 SAP patients,who were in the People's Hospital of Guangxi Zhuang Autonomous Region from March 2010 to March 2011,were selected,including 30 patients with diabetes and 46 patients with statin therapy. The circulating miR-92a was detected by RT - qPCR. The difference of the circulating miR-92a expression level in SAP patients with or without combination of diabetic and statin therapy;and the difference of the circulating miR-92a expression level in elderly SAP patients with or without statin therapy were compared. Results The expression level of miR-92a in SAP patients was(0. 53±0. 44). The results of Pearson correlation analysis showed that the age of SAP patients was positively correlated with the expression level of miR-92a( r = 0. 217,P = 0. 019). With the circulating miR - 92 as the dependent variables and age as covariate,covariance analysis showed that diabetes and age had interaction effects on the circulating miR-92a( F = 19. 631,P ﹤ 0. 05);statin therapy and age had interaction effects on the circulating miR-92a(F = 2. 346,P ﹤ 0. 05). The results of multi - factor analysis of variance showed that the expression level of circulating miR-92a in elderly SAP combined with diabetes patients who received statin therapy was lower than that in SAP patients who did not receive statin therapy(F = 22. 084,P = 0. 001);whether receiving statin therapy or not,the circulating miR-92a expression levels of SAP patients combined with diabetes showed no significant differences(F ﹤ 0. 001,P = 0. 992). Conclusion Diabetes and statin therapy have effect on the expression level of circulating miR-92a in SAP patients. Statin therapy can lower the circulating level of miR-92a in SAP patients combined with diabetes,which indicates that statin may improve endothelial function through regulating and contr