2025 年第 8 期 第 20 卷

急性ST段抬高型心肌梗死患者外周血内皮祖细胞微粒及微小RNA-126的表达变化和临床意义

Changes and clinical significance of peripheral blood endothelial progenitor cell microparticles and microRNA-126 expression in patients with acute ST-segment elevation myocardial infarction

作者：艾丽菲热·艾海提1刘柯2买力丹·买买提尼亚孜1迪丽尼格尔·阿里甫江1 麦迪乃姆·阿卜力孜1卡迪尔亚·依布拉音1穆叶赛·尼加提3

英文作者：Ailifeire Aihaiti1 Liu Ke2 Mailidan Maimaitiniyazi1 Dilinigeer Alifujiang1 Maidinaimu Abulizi1 Kadierya Yibulayin1 Muyesai Nijiati3

单位：1新疆医科大学研究生学院，乌鲁木齐830017；2石河子大学医学院，石河子832000；3新疆维吾尔自治区人民医院新疆急救中心，乌鲁木齐830001

英文单位：1Graduate School Xinjiang Medical University Urumqi 830017， China; 2Medical College，Shihezi University Shihezi 832000 China; 3Xinjiang Emergency Center People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830001 China

关键词：急性ST段抬高型心肌梗死；内皮祖细胞微粒；微小RNA-126；缺血再灌注损伤

英文关键词：AcuteST-segmentelevationmyocardialinfarction;Endothelialprogenitorcellmicroparticles; MicroRNA-126;Ischemia-reperfusioninjury

• 摘要：

• 目的 分析急性ST段抬高型心肌梗死(STEMI)患者缺血再灌注前后外周血内皮祖细胞微粒（EPC-MPs）及微小RNA-126（miR-126）的表达变化和临床意义。方法 选取2023年12月至2024年11月于新疆维吾尔自治区人民医院就诊且接受经皮冠状动脉介入治疗的急性STEMI患者共50例，根据术后是否发生心肌缺血再灌注损伤（MIRI）分为非MIRI组和MIRI组。收集患者临床资料，采集患者术前、术后即刻和术后4、12、24 h外周血。流式细胞术鉴定EPC-MPs并进行定量分析，实时荧光定量聚合酶链反应检测微粒中miR-126表达水平。Logistic回归方法分析相关指标与MIRI发生的关联，受试者工作特征曲线(ROC)评估其对MIRI发生的诊断价值。结果  研究期间共21例(42.0%)患者术后发生MIRI，纳入MIRI组，其余29例患者纳入非MIRI组。所有患者外周血EPC-MPs水平自术后起呈逐渐升高趋势；2组间，术后12 h前非MIRI组水平高于MIRI组，术后12 h及以后低于MIRI组，但差异均无统计学意义（均P＞0.05）。所有患者miR-126水平术后逐渐升高，术后12 h达峰值后下降；2组间，非MIRI组始终高于MIRI组，术后12 h和24 h时差异均有统计学意义(均P＜0.05)。多因素Logistic回归分析发现，术后24 h的miR-126水平与MIRI的发生独立相关(比值比=0.20，95%置信区间：0.04～0.87，P=0.031)，且ROC曲线下面积为0.810，敏感度为77.8%，特异度为76.2%。结论  急性STEMI患者再灌注后外周血EPC-MPs水平呈逐渐升高趋势，而miR-126水平先升高后下降，术后24 h miR-126可作为MIRI发生的潜在诊断指标。

• Objective To analyze the changes and clinical significance of peripheral blood endothelial progenitor cell microparticles (EPC-MPs) and microRNA-126 (miR-126) expression in patients with acute ST-segment elevation myocardial infarction (STEMI) before and after ischemia-reperfusion. Methods Fifty patients with acute STEMI who received percutaneous coronary intervention (PCI) treatment at People′s Hospital of Xinjiang Uygur Autonomous Region from December 2023 to November 2024 were selected. Based on whether myocardial ischemia-reperfusion injury (MIRI) occurred after PCI, they were divided into non-MIRI group and MIRI group. The clinical data of the patients were collected, and the peripheral blood of the patients was collected before PCI, immediately after PCI, and 4, 12, 24 h after PCI. Flow cytometry was used to identify and quantify EPC-MPs. Real-time fluorescent quantitative polymerase chain reaction was used to detect the expression level of miR-126 in microparticles. Logistic regression was used to analyze the correlation between relevant indicators and MIRI, and the receiver operating characteristic (ROC) curve was used to evaluate its diagnostic value for MIRI. Results During the study period, a total of 21 patients (42.0%) developed MIRI after PCI and were included in the MIRI group, and the remaining 29 patients were included in the non-MIRI group. The levels of EPC-MPs in peripheral blood of all patients showed a gradual increase trend after PCI. Between the two groups, the level of non-MIRI group was higher than that of MIRI group before 12 h after PCI, and lower than that of MIRI group after 12 h （all P＞0.05）. The level of miR-126 in all patients increased gradually after PCI, reached the peak at 12 h, and then decreased. Between the two groups, the non-MIRI group was always higher than the MIRI group, and the difference was statistically significant at 12 h and 24 h after PCI (both P＜0.05). Multivariate Logistic regression analysis showed that the level of miR-126 at 24 h after PCI was independently associated with MIRI (odds ratio=0.20, 95% confidence interval: 0.04-0.87, P=0.031), and the area under the ROC curve was 0.810, with a sensitivity of 77.8% and a specificity of 76.2%. Conclusion The level of EPC-MPs in peripheral blood of patients with acute STEMI increases gradually after reperfusion, while the level of miR-126 increases first and then decreases. MiR-126 can be used as a potential diagnostic indicator for MIRI at 24 h after PCI.