2025 年第 10 期 第 20 卷

急性心肌梗死患者血清长链非编码RNA表达对经皮冠状动脉介入术中冠状动脉无复流的预测价值研究

Study on the predictive value of serum long non-coding RNA expression in patients with acute myocardial infarction for coronary no-reflow during percutaneous coronary intervention

作者：董青1王学湘2徐莉3

英文作者：Dong Qing1 Wang Xuexiang2 Xu Li3

单位：1康复大学青岛医院山东省青岛市市立医院重症医学科，青岛266011；2康复大学青岛医院山东省青岛市市立医院急诊科，青岛266011；3康复大学青岛医院山东省青岛市市立医院心内一科，青岛266011

英文单位：1Department of Intensive Care Medicine Qingdao Hospital of University of Health and Rehabilitation Sciences Qingdao Municipal Hospital Shandong Province Qingdao 266011 China; 2Department of Emergency Qingdao Hospital of University of Health and Rehabilitation Sciences Qingdao Municipal Hospital Shandong Province Qingdao 266011 China; 3First Department of Cardiology Qingdao Hospital of University of Health and Rehabilitation Sciences Qingdao Municipal Hospital Shandong Province Qingdao 266011 China

关键词：急性心肌梗死；经皮冠状动脉介入；冠状动脉无复流；长链非编码RNA；HOX转录反义RNA；小核仁RNA宿主基因16

英文关键词：Acutemyocardialinfarction;Percutaneouscoronaryintervention;Coronaryno-reflow;Longnon-codingRNA;HOXtranscriptantisenseRNA;SmallnucleolarRNAhostgene16

• 摘要：

• 目的 探讨急性心肌梗死（AMI）患者血清长链非编码RNA（lncRNA）HOX转录反义RNA（HOTAIR）和小核仁RNA宿主基因16（SNHG16）表达对经皮冠状动脉介入（PCI）术中冠状动脉无复流（CNR）的预测价值。方法 选择2020年5月至2023年12月山东省青岛市市立医院收治的80例行PCI治疗的AMI患者，根据CNR发生情况将AMI患者分为CNR组（18例）和冠状动脉复流组（62例）。PCI术前检测血清lncRNA HOTAIR和lncRNA SNHG16表达，比较2组临床资料，分析PCI术中CNR发生的影响因素，采用受试者工作特征曲线分析lncRNA HOTAIR和lncRNA SNHG16预测AMI患者PCI术中CNR的价值。结果 CNR组发病至PCI时间≥6 h、病变血管长度≥20 mm比例、血清lncRNA SNHG16表达水平均高于冠状动脉复流组，血清lncRNA HOTAIR表达水平低于冠状动脉复流组，差异均有统计学意义（均P＜0.05）。Logistic回归分析结果显示病变血管长度≥20 mm、高lncRNA SNHG16均为AMI患者PCI术中CNR的危险因素，高lncRNA HOTAIR是AMI患者PCI术中CNR的保护因素（均P＜0.05）。lncRNA HOTAIR、lncRNA SNHG16预测AMI患者PCI术中CNR的曲线下面积分别为0.726、0.735，二者联合预测曲线下面积为0.947，高于单独预测（Z=2.560，P=0.011；Z=3.035，P=0.002）。结论 AMI患者lncRNA HOTAIR表达下降，lncRNA SNHG16表达增高与PCI术中CNR有关，可作为预测PCI术中CNR的标志物。

• Objective To investigate the predictive value of serum long non-coding RNA (lncRNA) HOX transcript antisense RNA (HOTAIR) and small nucleolar RNA host gene 16 (SNHG16) expression on coronary no-reflow (CNR) during percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A total of 80 AMI patients who underwent PCI in Qingdao Municipal Hospital, Shandong Province from May 2020 to December 2023 were selected. According to the occurrence of CNR, AMI patients were divided into CNR group (18 cases) and coronary reflow group (62 cases). The serum levels of lncRNA HOTAIR and lncRNA SNHG16 were detected before PCI. The clinical data of the two groups were compared, and the influencing factors of CNR during PCI were analyzed. The receiver operating characteristic curve was used to analyze the value of lncRNA HOTAIR and lncRNA SNHG16 in predicting CNR in AMI patients during PCI. Results The time from onset to PCI ≥6 h, the proportion of lesion vessel length ≥20 mm, and the expression level of serum lncRNA SNHG16 in the CNR group were higher than those in the coronary reflow group, and the expression level of serum lncRNA HOTAIR was lower than that in the coronary reflow group (all P<0.05). Logistic regression analysis showed that the length of diseased vessels ≥20 mm and high lncRNA SNHG16 were risk factors for CNR in AMI patients undergoing PCI, and high lncRNA HOTAIR was a protective factor for CNR in AMI patients undergoing PCI (all P<0.05). The area under the curve of lncRNA HOTAIR and lncRNA SNHG16 in predicting CNR in AMI patients during PCI was 0.726 and 0.735, respectively, and the area under the curve of the combination of lncrna HOTAIR and lncrna SNHG16 was 0.947, which was higher than that of single prediction (Z=2.560, P=0.011; Z=3.035, P=0.002). Conclusion The decreased expression of lncRNA HOTAIR in AMI patients, and the increased expression of lncRNA SNHG16 is related to the CNR during PCI, which can be used as a marker to predict the CNR during PCI.