血清miR-27a及Nrf2蛋白水平与急性心肌梗死患者PCI术后心肌缺血再灌注损伤的关系OA

Objective To investigate the relationship between serum miR-27a and nuclear factor erythroid 2-related factor 2(Nrf2)protein levels and myocardial ischemia-reperfusion injury(IRI)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 152 AMI patients who underwent PCI in the hospital from January 2021 to February 2024 were selected as the AMI group,and were divided into IRI group and non-IRI group according to whether myocardial IRI occurred after PCI.Another 78 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.The level of serum miR-27a was detected by real-time fluorescent quantita-tive polymerase chain reaction,and the level of Nrf2 protein was detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum miR-27a level and Nrf2 protein level in AMI patients.Multivariate Logistic regression was used to analyze the influencing factors of myocardial IRI in AMI patients after PCI.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum miR-27a and Nrf2 protein for myocardial IRI in AMI patients after PCI.Results The level of serum miR-27a in the AMI group was higher than that in the control group,and the lev-el of Nrf2 protein was lower than that in the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that serum miR-27a level was negatively correlated with Nrf2 level in AMI patients(r=-0.742,P<0.05).The Gensini score,and miR-27a level in the IRI group were higher than those in the non-IRI group,and the Nrf2 protein level was lower than that in the non-IRI group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the increase of Gensini score and miR-27a level were independent risk factors for myocardial IRI in AMI patients after PCI,and the increase of serum Nrf2 protein level was an independent protective factor for myo-cardial IRI in AMI patients after PCI(P<0.05).The area under the curve(AUC)of serum miR-27a and Nrf2 protein combined to predict myocardial IRI in AMI patients after PCI was 0.886,which was larger than the AUC of the two alone(0.799,0.785),and the differences were statistically significant(Z=3.231,3.403,P<0.05).Conclusion The increase of serum miR-27a level and the decrease of Nrf2 protein level are related to the occurrence of myocardial IRI in AMI patients after PCI.The combination of serum miR-27a and Nrf2 protein has a high predictive value for the occurrence of myocardial IRI in AMI patients after PCI.