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目的 探讨维持性血液透析患者检测微核糖核酸126(micro ribonucleic acid 126,miR-126)的临床意义.方法 60例维持性血液透析患者中45例并发冠心病,分为稳定性心绞痛15例(Ⅰ组)、不稳定性心绞痛12例(Ⅱ组)、非ST段抬高性心肌梗死10例(Ⅲ组)和ST段抬高性心肌梗死8例(Ⅳ组).无并发冠心病组15例.正常对照组40例.维持性血液透析患者采用颈部动脉彩超检查颈动脉内中膜厚度(intimal-medial wall thickness,IMT)和有无斑块,分为正常无增厚A组,内膜增厚患者B组,斑块形成患者C组和管腔狭窄患者D组.所有研究对象应用实时定量聚合酶链反应检测miR-126表达水平,并进行统计学分析. 结果 对照组与维持性血液透析患者并发冠心病组miR-126表达水平比较差异有统计学意义最小显著性差异(least—significant difference,LSD) t=8.553,P＜0.001),维持性血液透析患者有无并发冠心病组间比较差异有统计学意义(LSD-t=8.024,P＜0.001).A组到D组miR-126表达水平差别有统计学意义(F=11.219,P＜0.001).4组之间除A组和B组(LSD-t=0.203,P=1.252),C组和D组(LSD-t=0.193,P=1.342)比较差别无统计学意义外,其它组间比较差别均有统计学意义.Ⅰ组到Ⅳ组miR-126表达水平差异有统计学意义(F=6.342,P＜0.001).4组之间除Ⅰ组和Ⅱ组(LSD-t=0.173,P=1.349),Ⅲ组和Ⅳ组(LSD-t=0.225,P=1.024)比较差异无统计学意义外,其它组间比较差异均有统计学意义.冠心病不同类型组miR 126表达水平与低密度脂蛋白胆固醇含量呈显著负相关(r--0.358,P=0.031);而与高密度脂蛋白胆固醇含量呈显著正相关(r=0.405,P=0.029). 结论 miR-126检测可提示维持性血液透患者是否并发冠心病,对不同类型冠心病诊断有帮助.“,”Objective To investigate the clinical significance of miR-126 in patients on maintenance hemodialysis (MHD).Method In the 60 MHD patients,we found 45 cases complicated with coronary artery disease,including stable angina (n=15,group 1),unstable angina (n=12,group 2),non-ST segment elevated myocardial infarction (n=10,group 3) and ST segment elevated myocardial infarction (n=8,group 4),as well as 15 cases without coronary artery disease.Forty healthy people were recruited as controls.The 60 MHD patients were undergone ultrasonography to examine internal carotid arteies and to measure intimal-medial thickness (IMT) of internal carotid arteries.They were then divided in to group A (normal IMT,n=8),group B (abnormal IMT,n=7),group C (abnormal IMT with plaque,n=28),and group D (narrow vessel lumen,n=17).miR-126 was determined by real-time fluorescence quantitative PCR.Results There were significant differences in miR-126 expression level among MHD patients with and without coronary artery disease and normal controls (LSD,t=8.553,P=0.000),and between MHD patients with and without coronary artery disease (LSD,t=8.024,P=0.000).miR-126 expression level was statistically different among groups A,B,C and D (F=1 1.219,P=0.000) and between 2 of the 4 groups except for comparisons between groups A and B (LSD,t=0.203,P=1.252) and between groups C and D (LSD,t=0.193,P=1.342).miR-126 expression level was also statistically different among groups 1,2,3 and 4 (F=6.342,P=0.000) and between 2 of the 4 groups except for comparison between groups 1 and 2 (LSD,t=0.173,P=1.349) and between groups 3 and 4 (LSD,t=0.225,P=1.024).miR-126 expression level was negatively correlated with LDL-C (r=-0.358,P=0.031) and positively correlated with HDL-C (r=0.405,P=0.029).Conelusion Assay of miR-126 expression level is useful to suggest the complication of coronary artery disease and its clinical type in MHD patients.