本文選題：冠心病 + microRNA�。� 參考：《南京醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探索血漿microRNA的表達(dá)對(duì)于診斷冠心病和評(píng)估冠狀動(dòng)脈粥樣硬化嚴(yán)重程度的潛在生物學(xué)標(biāo)志物價(jià)值,并且探究microRNA的表達(dá)與傳統(tǒng)危險(xiǎn)因素對(duì)冠心病易感風(fēng)險(xiǎn)的交互作用。方法:本研究在2012至2013年期間,從中國伊犁哈薩克自治州友誼醫(yī)院心內(nèi)科住院治療的患者中納入共124例研究對(duì)象。冠狀動(dòng)脈造影確定66例冠心病病例組和58例非冠心病對(duì)照組,收集臨床資料并且采集靜脈血標(biāo)本。采用實(shí)時(shí)定量PCR(qRT-PCR)技術(shù)測(cè)定文獻(xiàn)已報(bào)道的與冠心病相關(guān)的20種microRNA的表達(dá)量。Gensini評(píng)分系統(tǒng)用以評(píng)判冠狀動(dòng)脈粥樣硬化的嚴(yán)重程度。使用叉生分析法計(jì)算各因素的比值比以及microRNA與傳統(tǒng)危險(xiǎn)因素在冠心病易感風(fēng)險(xiǎn)方面的交互作用。結(jié)果:冠心病組中血漿miR-125b的表達(dá)低于非冠心病組(0.14±0.09、0.18±0.10,p=0.055),差異趨向有意義。兩組間在年齡(p0.001)、男性性別(p=0.023)、高密度脂蛋白膽固醇(p=0.020)、血肌酐(p=0.033)、空腹血糖(p=0.006)、Gensini評(píng)分(p0.001)等傳統(tǒng)危險(xiǎn)因素方面差異具有統(tǒng)計(jì)學(xué)意義。并且隨著Gensini評(píng)分的增加,血漿miR-125b的表達(dá)量顯著降低(p=0.037)。此外,Spearman相關(guān)分析表明,Gensini評(píng)分與血漿miR-125b的表達(dá)呈負(fù)相關(guān)(r=-0.215,p=0.017)。受試者工作特征曲線顯示,在所有入選的20種miRNAs中,miR-125b診斷冠心病的曲線下面積AUC最小(0.405;95%CI:0.305～0.506,p=0.070)。叉生分析結(jié)果顯示miR-125b與冠心病傳統(tǒng)危險(xiǎn)因素之間存在交互作用。各自的交互作用指數(shù)為:年齡(SI=-50.99,SIM=5.48,AP=0.80);性別(SI=1.18,SIM=0.78,AP=0.12);CR(SI=1.46,SIM=1.00,AP=0.25);FBG(SI=1.25,SIM=0.77,AP=0.16);HDL-C(SI=1.50,SIM =0.92,AP=0.28)。值得注意的是miR-125b與年齡在冠心病交互作用的歸因比高達(dá)80%。結(jié)論:與對(duì)照組相比,miR-125b在冠心病患者體內(nèi)表達(dá)降低,并且隨著Gensini評(píng)分的增加,其表達(dá)量明顯減少。MiR-125b有望成為新的生物學(xué)標(biāo)志物用于臨床冠心病的診斷和冠狀動(dòng)脈粥樣硬化嚴(yán)重程度的評(píng)估。此外,miR-125b與傳統(tǒng)危險(xiǎn)因素對(duì)冠心病的易感風(fēng)險(xiǎn)存在明確的交互作用,對(duì)臨床早期篩選出更易罹患冠心病的高風(fēng)險(xiǎn)人群具有重要的意義。
[Abstract]:Objective: to explore the potential biomarker value of plasma microRNA expression in the diagnosis of coronary heart disease (CHD) and the severity of coronary atherosclerosis, and to explore the interaction between the expression of microRNA and traditional risk factors on the susceptibility to coronary heart disease (CHD). Methods: a total of 124 patients were enrolled in the study from 2012 to 2013 in the Department of Cardiology, Friendship Hospital of Yili Kazak Autonomous Prefecture, China. Coronary angiography confirmed 66 cases of coronary heart disease and 58 cases of non-coronary heart disease control group, collected clinical data and collected venous blood samples. The expression of 20 kinds of microRNA related to coronary artery disease (CHD) was measured by real-time quantitative PCRQ RT-PCR. Gensini scoring system was used to evaluate the severity of coronary atherosclerosis. The ratio ratio of each factor and the interaction between microRNA and traditional risk factors in the risk of coronary heart disease were calculated by using forked analysis method. Results: the expression of plasma miR-125b in coronary heart disease group was lower than that in non-coronary heart disease group (0.14 鹵0.09) 0.18 鹵0.10 p0. 055, and the difference tended to be significant. There were significant differences between the two groups in the traditional risk factors, such as age, male sex, high density lipoprotein cholesterol, serum creatinine, fasting blood glucose, and Gensini score (p 0.001), and there were significant differences between the two groups in the traditional risk factors, such as age, male sex, high density lipoprotein cholesterol, serum creatinine, and Gensini score (P 0.001). With the increase of Gensini score, the expression of plasma miR-125b decreased significantly. In addition, Spearman correlation analysis showed that there was a negative correlation between Gensini score and plasma miR-125b expression. The operating characteristic curve of the subjects showed that the area under the curve for diagnosing coronary heart disease (AUC) was 0.405% 95% CI: 0.305% 0.506% 0.506% and 0.070% under the curve for diagnosing coronary heart disease in all 20 kinds of miRNAs. Cross-birth analysis showed that there was interaction between miR-125b and traditional risk factors of coronary heart disease. Their interaction indexes were as follows: age sig 50.99 / SIMM 5.48 / 0.80; SIM-0.120.12. SIM1.00 / 0.25SIM0.77 / 0.16HDL-CIM0.50SIM 0.280.28. It is worth noting that the attribution ratio of the interaction between miR-125b and age in coronary heart disease is as high as 80. Conclusion: compared with the control group, the expression of miR-125b in patients with coronary heart disease decreased, and with the increase of Gensini score, The reduced expression of .MiR-125b is expected to be a new biomarker for the diagnosis of clinical coronary heart disease and the assessment of severity of coronary atherosclerosis. In addition, miR-125b has a clear interaction with traditional risk factors on the susceptibility to coronary heart disease, which is of great significance for screening the high-risk population with higher risk of coronary heart disease in the early clinical stage.
【學(xué)位授予單位】：南京醫(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)】：R541.4

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相關(guān)期刊論文 前1條

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本文編號(hào)：1860059