本文選題：新發(fā)心力衰竭　切入點(diǎn)：microRNA-499　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過(guò)研究血清microRNA-499(miR-499)在新發(fā)心力衰竭(New Onset Heart Failure)患者治療前后的表達(dá)變化,及其與氨基末端腦鈉肽前體(N terminal B type natriuretic peptide,NT-proBNP)、左心室射血分?jǐn)?shù)(left ventricular ejection fraction,LVEF)的相關(guān)性,評(píng)價(jià)miR-499在心力衰竭早期診斷中的價(jià)值,試圖尋找一種早期診斷心衰的新的生物標(biāo)志物。方法研究對(duì)象:2016年1月至2016年12月在上海市浦東新區(qū)公利醫(yī)院心血管內(nèi)科和急診科收治并明確診斷為第一次發(fā)生心力衰竭的患者共30例(心衰組),按NYHA(美國(guó)紐約心臟病學(xué)會(huì))標(biāo)準(zhǔn)對(duì)心功能進(jìn)行分級(jí)。選擇同年齡段在浦東新區(qū)公利醫(yī)院體檢中心的健康體檢人員30例作為對(duì)照組。采用熒光定量RT-PCR的方法,檢測(cè)心衰組所有個(gè)體治療前后和健康對(duì)照組所有個(gè)體外周血miR-499的表達(dá)水平,比較心衰組和對(duì)照組人群血清中miR-499表達(dá)水平的差異,比較心衰患者治療前后miR-499表達(dá)水平的變化,并分析miR-499與NT-proBNP、LVEF之間相關(guān)性。結(jié)果心力衰竭(heart failure,HF)組患者血清miR-499水平顯著高于健康對(duì)照組(P0.05),且治療后其表達(dá)水平下降;HF患者血清miR-499水平與NT-proBNP呈正相關(guān),與LVEF呈負(fù)相關(guān)。另外,ROC曲線(受試者工作特征曲線)分析顯示,對(duì)于HF的診斷miR-499具有特異性和敏感性,但并不優(yōu)于NT-proBNP。結(jié)論初發(fā)心衰患者血清miR-499表達(dá)升高,且與患者心功能等級(jí)存在正相關(guān)。血清miR-499表達(dá)水平與NT-proBNP、LVEF具有較好的相關(guān)性。經(jīng)抗心衰治療后血清mi R-499水平顯著下降。提示miR-499表達(dá)水平可能是一種早期診斷心力衰竭、評(píng)估患者病情嚴(yán)重程度的新的生物標(biāo)志物。
[Abstract]:Objective to study the changes of serum microRNA-499miR-499 in patients with new Onset Heart before and after treatment, and its correlation with N-terminal brain natriuretic peptide precursor N terminal B type natriuretic peptide NT-proBNPN, left ventricular ejection fraction (LVEF) and left ventricular ejection fractionation (LVEF). To evaluate the value of miR-499 in early diagnosis of heart failure. Objective: to seek a new biomarker for early diagnosis of heart failure. Methods: from January 2016 to December 2016, the patients were admitted to Department of Cardiovascular Medicine and Emergency Department of Gongli Hospital, Pudong New District, Shanghai, and diagnosed for the first time. A total of 30 patients with heart failure (heart failure group) were classified according to NYHA (New York Heart Association) standard. 30 healthy persons of the same age at Pudong New area Gongli Hospital physical examination Center were selected as control group. The method of fluorescence quantitative RT-PCR was used. To detect the expression of miR-499 in peripheral blood of all individuals in heart failure group and healthy control group before and after treatment, to compare the difference of miR-499 expression in serum between heart failure group and control group, and to compare the changes of miR-499 expression level before and after treatment in heart failure patients. Results the level of serum miR-499 in patients with heart failure was significantly higher than that in healthy controls (P 0.05), and the level of serum miR-499 in patients with HF was positively correlated with that of patients with HF after treatment. In addition, the analysis of ROC curve showed that the diagnosis of miR-499 in HF was specific and sensitive, but not superior to that of NT-proBNP.Conclusion the expression of miR-499 in serum of patients with primary heart failure is higher than that of NT-proBNP.Conclusion the expression of miR-499 in patients with HF is higher than that of NT-proBNPs. There was a positive correlation between the expression of serum miR-499 and NT-proBNPP LVEF. The level of serum miR-499 decreased significantly after anti-heart failure treatment. It suggested that the expression of miR-499 might be an early diagnosis of heart failure. A new biomarker for assessing the severity of a patient's condition.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.6

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