本文選題：環(huán)狀RNA + 急性心肌梗死　； 參考：《江蘇大學(xué)》2017年碩士論文

【摘要】：背景:急性心肌梗死(acute myocardial infarction,AMI)是心內(nèi)科常見急癥,是基于冠狀動(dòng)脈病變基礎(chǔ)上,突發(fā)的冠狀動(dòng)脈血流驟然減少或突然中斷,致使缺血部分冠脈所對(duì)應(yīng)的心肌細(xì)胞發(fā)生嚴(yán)重、持久的缺血,進(jìn)而造成局部心肌細(xì)胞的急性壞死。小腦變性相關(guān)蛋白1反義轉(zhuǎn)錄物(cerebellardegeneration-relatedprotein1antisense,CDR1as)是由人染色體X的反義鏈上的CDR1as基因外顯子經(jīng)反相剪切形成的環(huán)狀RNA(circularRNA,circRNA)。經(jīng)研究證實(shí)CDR1as在急性心肌梗死中有重要作用,但目前未見環(huán)狀RNA-CDR1as與急性心肌梗死患者危險(xiǎn)分層及梗死后早期室性心律失常關(guān)系的相關(guān)性研究。目的:初步探討急性心肌梗死(AMI)患者外周循環(huán)血液中環(huán)狀RNA-CDR1as與該患者危險(xiǎn)分層及梗死后早期室性心率失常的關(guān)系。方法:選取我院2016年1月29日至2016年8月29日,以突發(fā)急性胸痛為主要癥狀入胸痛中心,經(jīng)嚴(yán)格查體、心臟彩超、血液BNP尤其是心電圖、心梗三項(xiàng)確診為急性心肌梗死患者50例,分別于急診冠狀動(dòng)脈支架植入術(shù)(PCI)術(shù)前、術(shù)后24h、術(shù)后48h抽取患者外周循環(huán)血液,為排除其他疾病影響選50名非急性心肌梗死患者作對(duì)照,并選取10例健康成人作空白對(duì)照,利用基因芯片技術(shù)檢測(cè)外周血液中環(huán)狀RNA作為篩選試驗(yàn),以實(shí)時(shí)定量PCR行驗(yàn)證實(shí)驗(yàn),與此同時(shí)對(duì)于入選患者進(jìn)行嚴(yán)格而全面的急性冠脈事件評(píng)分(GRACE),并對(duì)入選患者行心電監(jiān)護(hù)及完善術(shù)后24h動(dòng)態(tài)心電圖。結(jié)果:1.環(huán)狀RNA-CDR1as在AMI組中較健康組有明顯升高(P0.05),且在疾病早期(PCI術(shù)前)即有升高,可穩(wěn)定存在于術(shù)后48h(P0.05);2.環(huán)狀RNA水平與患者梗死后危險(xiǎn)分層相關(guān)(P0.05);3.環(huán)狀RNA水平與患者梗死后室性心律失常明顯相關(guān)性(P0.05)。結(jié)論:環(huán)狀RNA-CDR1as在急性心肌梗死患者發(fā)病早期即可升高,可穩(wěn)定存在于術(shù)后48h,其水平與急性冠脈事件評(píng)分(GRACE)呈正相關(guān),因此與患者預(yù)后可能具有密切關(guān)聯(lián)。且環(huán)狀RNA-CDR1as水平與患者梗死后早期室性心律失常相關(guān)性明顯。
[Abstract]:Background: acute myocardial infarction (AMI) is a common emergency in cardiology. It is based on coronary artery disease. The sudden decrease or sudden interruption of coronary blood flow results in serious myocardial cells corresponding to the ischemic part of coronary artery. Persistent ischemia leads to acute necrosis of local myocardial cells. Cerebellardegeneration-related protein 1 antisense transcriptator CDR1asis a circular RNA-circRNAs formed by reverse shearing of CDR1as gene exons on antisense strand of human chromosome X. It has been confirmed that CDR1as plays an important role in acute myocardial infarction, but there is no correlation between annular RNA-CDR1as and risk stratification and ventricular arrhythmia in the early stage of acute myocardial infarction. Objective: to investigate the relationship between circulating RNA-CDR1as in peripheral blood and risk stratification and ventricular arrhythmia in patients with acute myocardial infarction (AMI). Methods: from January 29, 2016 to August 29, 2016, acute chest pain was selected as the main symptom of chest pain center. After strict physical examination, color Doppler echocardiography, blood BNP, especially electrocardiogram (ECG) were selected. Fifty patients with acute myocardial infarction diagnosed by three items of myocardial infarction were collected peripheral circulation blood before PCI, 24 hours after PCI, 48 hours after operation, respectively. In order to exclude the influence of other diseases, 50 non-acute myocardial infarction patients were selected as control group and 10 healthy adults as blank control. The detection of circular RNA in peripheral blood by gene chip technique was used as screening test, and real-time quantitative PCR was used to verify the results. At the same time, the patients were given strict and comprehensive acute coronary events score (ACAE) and electrocardiogram (ECG) monitoring. The result is 1: 1. Annular RNA-CDR1as was significantly higher in AMI group than that in healthy group, and increased significantly in the early stage of the disease. It could be stable at 48h after operation (P0.05 / 2). The level of annular RNA was correlated with risk stratification after infarction (P 0.05). The level of annular RNA was significantly correlated with ventricular arrhythmias after infarction (P 0.05). Conclusion: cyclic RNA-CDR1as can be increased at the early stage of acute myocardial infarction and can exist steadily at 48 hours after operation. The level of cyclic RNA-CDR1as is positively correlated with the acute coronary event score (ACAE), so it may be closely related to the prognosis of the patients. The level of annular RNA-CDR1as was associated with early ventricular arrhythmia after infarction.
【學(xué)位授予單位】：江蘇大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R542.22

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