本文選題：miRNA + 頸動脈狹窄��； 參考：《西南醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:檢測并比較頸動脈狹窄患者和對照人群外周血液循環(huán)miRNA146a、miR-4284、miR-4463、miR-4306、miR-210、miR-221動態(tài)表達水平,探討其與頸動脈狹窄的關(guān)系及血管支架植入對其影響,以及作為頸動脈狹窄診斷標志物的可行性。方法:選取27例已行頸內(nèi)支架植入術(shù)的血管頸動脈狹窄患者,分別在術(shù)前2天內(nèi)、術(shù)后24 h內(nèi)、術(shù)后1月,術(shù)后3月抽取肘靜脈血液,全血提取總RNA,用實時定量PCR(RT-PCR)方法,檢測兩組外周循環(huán)血液中miRNA146a、miRNA4284、miRNA4463、miRNA4306、miRNA210、miRNA221的動態(tài)表達量是否有差異;使用SPSS13.0統(tǒng)計軟件進行數(shù)據(jù)的統(tǒng)計分析,計數(shù)資料以平均值±標準差(x±S)表示,組間均數(shù)比較采用t檢驗,采用單因素方差分析完成多個樣本均值之間的比較,率的比較采取卡方檢驗,P0.05認為差異具有統(tǒng)計學(xué)意義,每次檢驗重復(fù)不低于3次。結(jié)果:與對照相比,(1)頸動脈狹窄患者頸內(nèi)支架植入術(shù)前血液中miRNA146a上升5.48倍、miRNA4284上升13.83倍、miRNA4463上升23.37倍、miRNA4306上升21.02倍、miRNA210上升3.87倍、miRNA221上升3.05倍,P值均0.05,(2)頸內(nèi)支架植入術(shù)后24h時miRNA146a進一步上升至14.17倍、miRNA4284進一步上升至41.66倍、miRNA210進一步上升至9.39倍、miRNA221進一步上升至19.07倍,而miRNA4463和miRNA4306表達分別下降至4.02和17.17倍,與對照相比差異具有統(tǒng)計學(xué)意義(P0.05),(3)頸內(nèi)支架植入術(shù)后1月時,mirna146a降低至對照組的11.26倍、mirna4284降低至對照組的6.17倍、mirna4463降低至對照組的2.5倍、mirna4306降低至對照組的13.39倍、mirna210分別降低至對照組的3.03倍,p值均0.05,而mir-221表達水平與對照無顯著差異(p0.05),(4)頸內(nèi)支架植入術(shù)后3月時mirna146a重新回升至對照組的12.85倍、mirna4284重新回升至對照組的27.00倍、mirna4463重新回升至對照組的108.47倍、mirna4306重新回升至對照組的35.20倍、mirna210重新回升至對照組的24.48倍,以上差異均具有統(tǒng)計學(xué)意義(p值均0.05),在頸動脈支架手術(shù)前術(shù)后的比較中,(1)頸動脈狹窄患者血漿中,mir-221的表達顯著上升(p0.05),其在支架植入術(shù)前、術(shù)后24h、術(shù)后隨訪1月、術(shù)后隨訪3月表達均有統(tǒng)計學(xué)意義(p0.05);(2)mir-210在支架植入術(shù)前、術(shù)后24h、術(shù)后隨訪3月表達有統(tǒng)計學(xué)意義(p0.05);但術(shù)前與術(shù)后1月比較時比較無統(tǒng)計學(xué)意義(p0.05);(3)mir-4284術(shù)后3月與術(shù)前、與術(shù)后24h、術(shù)后1月比較時表達均有統(tǒng)計學(xué)意義(p0.05);(4)mir-4306術(shù)后1月與術(shù)后3月比較時表達有統(tǒng)計學(xué)意義(p0.05),余均無統(tǒng)計學(xué)意義(p0.05);(5)mir-4463術(shù)后3月表達有統(tǒng)計學(xué)意義(p0.05),余均無統(tǒng)計學(xué)意義(p0.05);(6)mirna146a表達均無明顯統(tǒng)計學(xué)意義(p0.05)。結(jié)論:(1)mirna146a、mirna4284、mirna4463、mirna4306、mirna210、mirna221可能參與了頸動脈狹窄的形成過程,并在頸動脈支架置入術(shù)后的病理生理過程中發(fā)揮作用,提示其有望成為臨床早期診斷頸動脈狹窄的生物學(xué)標志,并作為頸動脈狹窄患者發(fā)病和病情進展的新型標志物;(2)mir-4463在術(shù)后3月變化明顯,其高表達可能與支架植入術(shù)后慢性期血管重塑再狹窄有關(guān),可能成為一個遠期預(yù)測再狹窄的新型標志物,但由于樣本量較小,需擴大樣本量以進一步證實。
[Abstract]:Objective: to detect and compare the dynamic expression of miRNA146a, miR-4284, miR-4463, miR-4306, miR-210, miR-221 in the peripheral blood circulation of patients with carotid stenosis and control, and to explore the relationship between the carotid stenosis and the carotid stenosis and the effect of stent implantation, as well as the feasibility of the diagnostic marker of carotid stenosis. Methods: 27 cases have been selected. The patients with carotid artery stenosis with internal stent implantation were within 2 days before operation, 24 h after operation, the blood was extracted from the elbow vein in January, and the total RNA was extracted in the whole blood, and the real-time quantitative PCR (RT-PCR) method was used to detect the dynamic expression of miRNA146a, miRNA4284, miRNA4463, miRNA4306, miRNA210, miRNA221 in the two groups of peripheral circulation blood. Difference; using SPSS13.0 statistical software to carry out statistical analysis of data, the count data is expressed with mean mean standard deviation (x + S), and the average number of groups is compared with t test. The comparison of the mean values of multiple samples is completed by single factor analysis of variance. The comparison of rate is taken by chi square test. P0.05 believes that the difference is statistically significant, and each test repeats is not repeated. Results below 3 times. Results: (1) miRNA146a increased 5.48 times in blood before carotid artery stent implantation in patients with carotid artery stenosis, miRNA4284 increased 13.83 times, miRNA4463 increased 23.37 times, miRNA4306 increased 21.02 times, miRNA210 increased 3.87 times, miRNA221 increased 3.05 times, P value was 0.05, and miRNA146a further increased after internal carotid stent implantation (2). To 14.17 times, miRNA4284 increased further to 41.66 times, miRNA210 further increased to 9.39 times, miRNA221 further increased to 19.07 times, while miRNA4463 and miRNA4306 decreased to 4.02 and 17.17 times respectively, compared with the control (P0.05), (3) mirna146a decreased to 11.26 of the control group in January after the stent implantation. Mirna4284 decreased to 6.17 times of the control group, mirna4463 decreased to 2.5 times of the control group, mirna4306 decreased to 13.39 times of the control group, mirna210 decreased to 3.03 times of the control group, P value was 0.05, and the miR-221 expression level was not significantly different from the control (P0.05), and (4) the mirna146a recovered to 12 of the control group in March after the internal stent implantation. .85 times, mirna4284 recovered 27 times to the control group, and mirna4463 recovered to 108.47 times as much as the control group. Mirna4306 again recovered to 35.20 times of the control group, and mirna210 recovered to 24.48 times of the control group. The above differences were statistically significant (P value 0.05), and (1) carotid stenosis in the preoperative and postoperative comparison of carotid artery stents. In the plasma of narrow patients, the expression of miR-221 was significantly increased (P0.05). Before stent implantation, postoperative 24h, postoperative follow-up and follow-up in March were statistically significant (P0.05). (2) mir-210 before stent implantation, postoperative 24h, postoperative follow-up was statistically significant (P0.05), but there was no statistical difference between preoperative and January after the operation. Significance (P0.05); (3) the expression of mir-4284 was statistically significant (P0.05) in March and before operation, compared with postoperative 24h and postoperative January; (4) there was statistical significance (P0.05) in January and March after mir-4306 operation (P0.05); (5) there was statistical significance (P0.05) in March after operation (P0), and there was no statistical significance (P0). .05); (6) there is no significant statistical significance in mirna146a expression (P0.05). Conclusion: (1) mirna146a, mirna4284, mirna4463, mirna4306, mirna210, mirna221 may be involved in the formation of carotid stenosis and play a role in the pathophysiological process of carotid artery stenting, suggesting that it is expected to be a clinical early diagnosis of carotid stenosis. Biological markers and as a new marker for the onset and progression of patients with carotid stenosis; (2) mir-4463 changes in March after operation, and its high expression may be associated with chronic vascular restenosis after stent implantation, which may be a new marker for long-term prediction of restenosis. However, it is necessary to expand the sample size due to the small sample size. The amount is further confirmed.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R651.12

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