Objective: To investigate the correlation of the expression of platelet microRNA-223 (miR-223) with the degree of platelet activation and the severity of coronary lesions in patients with coronary artery disease (CAD). Methods: A total of 204 consecutive patients underwent coronary artery angiography (CAG) at Beijing Anzhen Hospital between April and December 2016 were enrolled. According to CAG results, all the patients were divided into two groups: 112 patients in CAD group and 92 patients in control group. Real-time fluorescent quantitative PCR was used to detect the expression level of platelet miR-223 and mRNA of its target gene P2Y12. Flow cytometry was performed to detect the expression of platelet associated complement-1 (PAC-1). Results: Compared with control group, the expression level of platelet miR-223 in CAD group was higher [(1.27 (1.17, 1.32) vs 0.73 (0.64, 0.79), P<0.001], while the expression level of P2Y12 mRNA was lower [0.75 (0.51, 0.96) vs 1.00 (0.80, 1.64), P<0.001]. The positive expression rate of PAC-1 of CAD group was higher than that of control group (P<0.001). The expression level of platelet miR-223 was negatively correlated with the expression of P2Y12 (r=-0.39, P=0.02), but positively correlated with the expression of PAC-1 (r=0.50, P<0.001). The platelet miR-223 expression level had a positive correlation with the Gensini score in CAD group (r=0.90, P<0.001), but had no significant correlation with platelet aggregation (r=-0.06, P=0.36). Conclusion: The expression level of platelet miR-223 in patients with CAD may be an indicator for monitoring platelet activation and assessing the severity of CAD.
目的： 探讨冠心病患者血小板微小RNA－223(microRNA－223，miR－223)的表达变化与血小板活化程度以及冠脉病变严重程度的相关性。 方法： 连续入选2016年4至12月入住北京安贞医院心内科行冠脉造影(CAG)检查的患者204例，根据CAG结果分为：冠心病组112例，对照组92例。采用实时荧光定量PCR检测冠心病组和对照组患者血小板miR－223及其靶基因P2Y12 mRNA的表达水平，采用细胞流式仪检测两组患者血液中血小板活化标志物血小板膜糖蛋白纤维蛋白原受体(PAC－1)的表达情况。 结果： 冠心病患者血小板miR－223表达水平为1.27(1.17，1.32)，明显高于对照组0.73(0.64，0.79)(P<0.001)；P2Y12 mRNA的表达水平为0.75(0.51，0.96)，明显低于对照组1.00(0.80，1.64)( P<0.001)；冠心病患者血液中血小板活化标志物PAC－1的阳性表达率高于对照组(P<0.001)。相关性分析显示，血小板miR－223的表达水平与P2Y12的表达水平呈显著负相关(r＝－0.39，P＝0.02)，与PAC－1阳性表达率呈显著正相关(r＝0.50，P<0.001)。冠心病患者血小板miR－223表达水平与反映冠脉病变严重程度的Gensini评分呈显著正相关(r＝0.90，P<0.001)，与血小板最大聚集率无明显相关性(r＝－0.06, P＝0.36)。 结论： 冠心病患者血小板miR－223表达水平可能成为监测其血小板活化程度和评估冠状动脉严重程度的指标。.
Keywords: Coronary artery disease; Gensini score; MiR-223; Platelet activation.