【摘要】：目的本課題主要研究micro RNA-3146(miR-3146)在急性痛風(fēng)性關(guān)節(jié)炎患者的表達(dá)水平,分析其對(duì)痛風(fēng)的診斷價(jià)值,并研究其與關(guān)鍵炎癥因子的相關(guān)關(guān)系。方法入選2015年1月至12月在青大附院就診的急性痛風(fēng)性關(guān)節(jié)炎、單純高尿酸血癥(HUA)患者各31例,另隨機(jī)選取健康對(duì)照32例。收集患者臨床信息,采集外周靜脈血測(cè)空腹血糖、尿酸、肝功、腎功等指標(biāo);采用逆轉(zhuǎn)錄PCR方法檢測(cè)血漿mi R-3146水平,并采用ELISA法檢測(cè)血漿TNF-α和IL-1β水平。利用統(tǒng)計(jì)軟件分析mi R-3146在急性痛風(fēng)性關(guān)節(jié)炎組、HUA組和正常對(duì)照組之間的表達(dá)差異,采用ROC曲線評(píng)估其對(duì)急性痛風(fēng)性關(guān)節(jié)炎的診斷意義,分析mi R-3146與TNF-α、IL-1β的相關(guān)關(guān)系,并分析秋水仙堿治療是否可改變患者血漿mi R-3146水平。結(jié)果急性痛風(fēng)性關(guān)節(jié)炎患者血漿miR-3146水平明顯高于單純HUA患者(P=0.002)和健康對(duì)照者(P=0.0002)。急性痛風(fēng)性關(guān)節(jié)炎組和HUA組的血漿mi R-3146水平與年齡、血壓、血脂、肝功和腎功等指標(biāo)均無(wú)相關(guān)性(P0.05)。急性痛風(fēng)性關(guān)節(jié)炎患者血漿中mi R-3146水平與血漿TNF-α水平呈正相關(guān)(Spearman r=0.55,P=0.014),血漿mi R-3146水平與血漿IL-1β水平也呈正相關(guān)(Spearman r=0.53,P=0.002)。ROC曲線顯示血漿mi R-3146水平對(duì)急性痛風(fēng)性關(guān)節(jié)炎有一定的診斷價(jià)值,曲線下面積為0.725(95%CI:0.596-0.854)。急性痛風(fēng)性關(guān)節(jié)炎患者經(jīng)秋水仙堿治療后血漿中mi R-3146水平較治療前明顯降低(P=0.026)。生物信息學(xué)預(yù)測(cè)的mi R-3146可能的靶基因包括ADAMTS4、ADAMTS19、SLC16A1、CXCR6等基因。結(jié)論mi R-3146在急性痛風(fēng)性關(guān)節(jié)炎患者血漿中呈特異性高表達(dá),其表達(dá)水平與TNF-α、IL-1β水平存在正相關(guān)關(guān)系,說(shuō)明mi R-3146可能參與了痛風(fēng)的發(fā)病過(guò)程。血漿mi R-3146對(duì)急性痛風(fēng)性關(guān)節(jié)炎的有一定的診斷價(jià)值。秋水仙堿可降低急性痛風(fēng)性關(guān)節(jié)炎患者血漿中mi R-3146的表達(dá)水平。
[Abstract]:Objective to study the expression level of micro RNA-3146 (miR-3146) in patients with acute gouty arthritis, analyze its diagnostic value and study the relationship between miR-3146 and key inflammatory factors. Methods from January to December, 2015, 31 patients with acute gouty arthritis, 31 patients with hyperuricemia (HUA) and 32 healthy controls were selected. Clinical information was collected, fasting blood glucose, uric acid, liver function and renal function were measured by peripheral venous blood samples, plasma mi R-3146 levels were detected by reverse transcription PCR method, plasma TNF- 偽 and IL-1 尾 levels were detected by ELISA method. The expression of mi R-3146 in patients with acute gouty arthritis was analyzed by statistical software. The significance of mi R-3146 in diagnosis of acute gouty arthritis was evaluated by ROC curve, and the correlation between mi R-3146 and TNF- 偽 IL-1 尾 was analyzed. Whether colchicine treatment can change plasma mi R-3146 level was analyzed. Results Plasma miR-3146 levels in patients with acute gouty arthritis were significantly higher than those in patients with HUA alone (P0. 002) and healthy controls (P0. 0002). There was no correlation between plasma mi R-3146 level and age, blood pressure, blood lipid, liver function and renal function in acute gouty arthritis group and HUA group (P0.05). There was a positive correlation between plasma mi R-3146 level and plasma TNF- 偽 level in patients with acute gouty arthritis (Spearman rr 0.55U Pn0. 014), and there was a positive correlation between plasma mi R-3146 level and plasma IL-1 尾 level (Spearman rn 0.53P 0. 002) .ROC curve showed that plasma mi R-3146 level had certain diagnostic value for acute gouty arthritis. The area under the curve is 0.725 (95%CI:0.596-0.854). The level of mi R-3146 in plasma of patients with acute gouty arthritis after colchicine treatment was significantly lower than that before treatment (P0. 026). Bioinformatics predicted possible target genes of mi R-3146 include ADAMTS4,ADAMTS19,SLC16A1,CXCR6 and so on. Conclusion the expression of mi R-3146 in plasma of patients with acute gouty arthritis is highly specific, and there is a positive correlation between the expression level of mi R-3146 and the level of TNF- 偽 -IL-1 尾, indicating that mi R-3146 may be involved in the pathogenesis of gout. Plasma mi R-3146 has certain diagnostic value for acute gouty arthritis. Colchicine decreased the expression of mi R-3146 in plasma of patients with acute gouty arthritis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R589.7

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