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中华危重症医学杂志(电子版)

中华危重症医学杂志(电子版) ›› 2017, Vol. 10 ›› Issue (05) : 316 -321. doi: 10.3877/cma.j.issn.1674-6880.2017.05.005

所属专题： 文献；

论著

心肺复苏后大鼠血浆中微小核糖核酸在心肌损伤中的变化及其意义
江哲龙1, 王东升2, 何爱文2, 许华清2, 周志良2, 陈寿权2, 李章平2,†(), 李惠萍2, 黄唯佳2, 程俊彦2   
  1. 1. 310006　杭州，杭州市第一人民医院急诊科
    2. 325000　浙江温州，温州医科大学附属第一医院急诊科
  • 收稿日期:2016-08-16 出版日期:2017-10-01
  • 通信作者: 李章平
  • 基金资助:
    浙江省自然科学基金项目(LY16 h150008); 温州市科技项目(Y20140675、Y20090241)

Changes of plasma microRNA of rats in myocardial injury after cardiopulmonary resuscitation and their significance

Zhelong Jiang1, Dongsheng Wang2, Aiwen He2, Huaqing Xu2, Zhiliang Zhou2, Shouquan Chen2, Zhangping Li2,†(), Huiping Li2, Weijia Huang2, Junyan Cheng2   

  1. 1. Department of Emergency, Hangzhou First People's Hospital, Hangzhou 310006, China
    2. Department of Emergency, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • Received:2016-08-16 Published:2017-10-01
  • Corresponding author: Zhangping Li
  • About author:
    Corresponding author: Li Zhangping, Email:
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引用本文：

江哲龙, 王东升, 何爱文, 许华清, 周志良, 陈寿权, 李章平, 李惠萍, 黄唯佳, 程俊彦. 心肺复苏后大鼠血浆中微小核糖核酸在心肌损伤中的变化及其意义[J/OL]. 中华危重症医学杂志(电子版), 2017, 10(05): 316-321.

Zhelong Jiang, Dongsheng Wang, Aiwen He, Huaqing Xu, Zhiliang Zhou, Shouquan Chen, Zhangping Li, Huiping Li, Weijia Huang, Junyan Cheng. Changes of plasma microRNA of rats in myocardial injury after cardiopulmonary resuscitation and their significance[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2017, 10(05): 316-321.

目的

本研究探讨心肺复苏后大鼠血浆中心肌损伤相关微小核糖核酸（miRNA）的变化及其意义。

方法

将64只Sprague-Dawley大鼠分为对照组和实验组，每组各32只。采用窒息法建立大鼠心肺复苏模型，两组分别于气管切开后（对照组）或心肺复苏后（实验组）3、6、12、24 h取静脉血，检测各时间点血浆miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-210、miRNA-320及miRNA-499的表达水平，并采用受试者工作特征（ROC）曲线的曲线下面积评价两组大鼠血浆各miRNA对心搏骤停-心肺复苏后心肌损伤的预测价值。

结果

实验组与对照组间不同时间点miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-210、miRNA-320和miRNA-499相对表达量比较，差异均有统计学意义（F = 223.037、635.809、51.557、167.260、93.157、296.361、622.023，P均< 0.001）；进一步两两比较发现，miRNA-1、miRNA-133a和miRNA-499在各时间点的相对表达量较对照组均明显上升（P均< 0.05）；而miRNA-21在各时间点相对表达量较对照组均显著下降（P均< 0.001）；此外，miRNA-126在3、6、12 h的相对表达量较对照组均明显下调（P均< 0.001），而在24 h的相对表达量与对照组比较则显著上调（P < 0.001）。miRNA-210在6 h、12 h的相对表达量和miRNA-320在3、6、12 h的相对表达量较对照组均呈上调趋势（P均< 0.05）。实验组中，miRNA-1，miRNA-133a，miRNA-210在3 h的相对表达量与24 h的相对表达量比较，差异均无统计学意义（P均> 0.05），其余各时点比较差异均具有统计学意义（P均< 0.05）；miRNA-21和miRNA-126在3 h与6 h的相对表达量比较、6 h与12 h的相对表达量比较，差异均无统计学意义（P均> 0.05），其余各时间点间的相对表达量比较，差异均有统计学意义（P均< 0.05）；而miRNA-320和miRNA-499各个时间点的相对表达量比较，差异均有统计学意义（P均< 0.05）。ROC曲线分析结果显示miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499的ROC曲线下面积分别为：0.938、0.912、0.859、0.914、0.805和0.969，敏感度分别为：0.750、1.000、0.875、0.750、1.000和0.875，特异度分别为：1.000、0.750、0.750、1.000、0.750和1.000（P均< 0.05），提示miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499对心肺复苏后心肌损伤具有预测价值。

结论

大鼠心肺复苏后血浆中各miRNA的相对表达量在心肌损伤中有不同的变化，其中miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-320及miRNA-499对心肺复苏后心肌损伤均具有预测价值。

关键词: 心肺复苏, 心肌损伤, 微小核糖核酸, 大鼠
Objective

To study changes of plasma microRNA (miRNA) of rats in myocardial injury after cardiopulmonary resuscitation and their significance.

Methods

A total of 64 Sprague-Dawley rats were divided into the control group and the experimental group, 32 rats in each group. The rat model of cardiopulmonary resuscitation was established by asphyxia. The levels of plasma miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-210, miRNA-320 and miRNA-499 were detected at different time points when the two groups received venous blood after tracheotomy (the control group) or cardiopulmonary resuscitation (the experimental group) 3, 6, 12, 24 h respectively. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma miRNA for myocardial injury after cardiac arrest-cardiopulmonary resuscitation in the two groups.

Results

The relative values of miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-210, miRNA-320 and miRNA-499 in the experimental group showed statistical differences as compared with the control group in different time pionts (F = 223.037, 635.809, 51.557, 167.260, 93.157, 296.361, 622.023, all P < 0.001). In comparison with the control group, the relative expressions of miRNA-1, miRNA-133a and miRNA-499 in the experimental group significantly increased in each time point (all P < 0.05), while the relative expression of miRNA-21 all reduced (all P < 0.001). In addition, the relative expression of miRNA-126 in the experimental group at 3, 6 and 12 h were significantly lower than that in the control group (all P < 0.001); however it at 24 h was significantly higher than that in the control group (P < 0.001). The relative expressions of miRNA-210 at 6 h and 12 h and miRNA-320 at 3, 6 and 12 h in the experimental group showed an upward trend as compared with the control group (all P < 0.05). In the experimental group, the relative expressions of miRNA-1, miRNA-133a and miRNA-210 at 3 h showed no significant differences as compared with those at 24 h (all P > 0.05), while there were significant differences in the rest of time points (all P < 0.05). At the same time, the relative expressions of miRNA-21 and miRNA-126 between 3 h and 6 h, 6 h and 12 h had no statistically significant differences (all P > 0.05), but there were significant differences in the rest of time points (all P < 0.05). However, the relative expressions of miRNA-320 and miRNA-499 at each time point had statistical differences (all P < 0.05). ROC curve analysis results showed that the areas under the ROC curve of miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-320 and miRNA-499 were 0.938, 0.912, 0.859, 0.914, 0.805 and 0.969 respectively, their sensitivity were 0.750, 1.000, 0.875, 0.750, 1.000 and 0.875, and their specificity were 1.000, 0.750, 0.750, 1.000, 0.750 and 1.000 (all P < 0.05), which suggested that miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-320 and miRNA-499 had predictive value for myocardial injury after cardiopulmonary resuscitation.

Conclusion

The relative expression of plasma miRNA of rats has different changes in myocardial injury after cardiopulmonary resuscitation, and miRNA-1, miRNA-21, miRNA-126, miRNA-133a, miRNA-320 and miRNA-499 have predictive value for myocardial injury after cardiopulmonary resuscitation.

Key words: Cardiopulmonary resuscitation, Myocardial injury, MicroRNA, Rat
表1 两组大鼠基本资料比较（ ± s）
组别 只数 体质量（g） 水合氯醛用量（mL） MAP基础值（mmHg）
实验组 32 300 ± 17 2.10 ± 0.12 104 ± 8
对照组 32 298 ± 17 2.07 ± 0.11 105 ± 7
t值 ? 0.412 1.095 0.721
P值 ? 0.657 0.237 0.475
图1 实验组与对照组大鼠不同时间点血浆miRNA-1、miRNA-21、miRNA-126、miRNA-133a、miRNA-210、miRNA-320和miRNA-499相对表达量的比较。注：与对照组比较，*P < 0.05；与实验组3 h比较，#P < 0.05；与实验组6 h比较，+P < 0.05；与实验组12 h比较，&P < 0.05
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