本文選題：小兒先心病 + 肺動脈高壓�。� 參考：《北京協(xié)和醫(yī)學院》2016年碩士論文

【摘要】：目的：通過探索小兒先心病肺動脈高壓(pulmonary arterial hypertension,PAH)患者血清腦利尿肽(brain natriuretic factor or peptide,BNP)的濃度和microRNA (miRNA)的表達水平,研究它們與PAH的關(guān)系及彼此之間的相關(guān)性,從而為先心病肺動脈高壓的診斷提供幫助。方法：收集泰達國際心血管病醫(yī)院2015年10月至2016年4月收治確診為先天性心臟病患者39例。其中男性21例,女性18例。根據(jù)2008年肺動脈高壓國際論壇會公布的肺動脈高壓的診斷標準進行分組,分別為先天性心臟病肺動脈壓力正常組16例(A組)；先天性心臟病合并輕、中度肺動脈高壓組(B組)15例和先天性心臟病重度動脈高壓組(c組)8例。采集受試者外周靜脈血,利用BNP免疫反應(yīng)試劑盒對血清BNP濃度進行檢測；同時利用實時定量PCR對miRNA表達量進行測定。利用SPSS軟件對數(shù)據(jù)進行ANOVA分析,并做ROC曲線,同時利用Person相關(guān)性分析BNP與miRNA共同診斷PAH的合同效果。結(jié)果：(1)對受試者血清BNP濃度進行檢測,結(jié)果顯示,先心病肺高壓重度患者血清BNP濃度為183.35±6.36,明顯高于有先心病但肺動脈血壓正常組(p0.01)。(2)肺動脈重度患者miRNA19a表達量為3.28±0.26,顯著高于A、B組。ROC曲線下方面積為0.906.(3) BNP與miRNA-19a之間的相關(guān)性為0.778,具有統(tǒng)計學差異。結(jié)論：1小兒先心病肺動脈高壓患者血清BNP濃度可以作為臨床診斷指標2.miRNA-19a在先心病肺動脈早期表達量都有所增加,可作為早期預(yù)警指標。3.BNP濃度和miRNA-19a的相關(guān)性較高,可以協(xié)同作用,提高確診率。
[Abstract]:Objective: to investigate the serum concentration of brain natriuretic factor or microRNA miRNAs in children with pulmonary arterial hypertensionation of congenital heart disease, and to study the relationship between PAH and serum brain natriuretic factor or microRNA miRNAs. It is helpful for the diagnosis of pulmonary hypertension of congenital heart disease. Methods: 39 patients with congenital heart disease were collected from October 2015 to April 2016 in Teda International Cardiovascular Hospital. There were 21 males and 18 females. According to the diagnostic criteria of pulmonary hypertension published by the International Forum on Pulmonary Hypertension in 2008, 16 patients with congenital heart disease with normal pulmonary artery pressure were divided into two groups: group A, congenital heart disease complicated with mild heart disease, 15 cases in group B of moderate pulmonary hypertension and 8 cases in group C of severe congenital heart disease. The peripheral venous blood was collected and the serum BNP concentration was detected by BNP immunoassay kit, and the expression of miRNA was measured by real-time quantitative PCR. The SPSS software is used to analyze the data by ANOVA, and the ROC curve is made. At the same time, the Person correlation analysis is used to analyze the contract effect of BNP and miRNA in the diagnosis of PAH. Results the serum BNP concentration of the subjects was measured and the results showed that, The level of serum BNP in patients with severe pulmonary hypertension was 183.35 鹵6.36, which was significantly higher than that in patients with CHD but normal pulmonary blood pressure (P 0.01). The expression of miRNA19a in patients with severe pulmonary artery was 3.28 鹵0.26, which was significantly higher than that in group A B, where the area under the curve was 0.906.63) between BNP and miRNA-19a. The correlation was 0.778, with statistical difference. Conclusion the serum BNP concentration in children with congenital heart disease and pulmonary hypertension can be used as a clinical diagnostic index to increase the expression of 2.miRNA-19a in the early stage of pulmonary artery disease, and it can be used as an early warning index. 3. The correlation between the concentration of BNP and miRNA-19a is relatively high, and it can be used as a synergistic index. Increase the rate of diagnosis.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R725.4

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