本文選題：冠心病 + 糖尿病�。� 參考：《廣州醫(yī)科大學》2017年碩士論文

【摘要】：【研究背景】冠狀動脈粥樣硬化性心臟病是指在多種致病因素作用下導(dǎo)致冠狀動脈粥樣硬化,引起冠狀動脈管腔狹窄甚至閉塞,從而導(dǎo)致心肌細胞缺血、缺氧或者壞死而引發(fā)的臨床綜合征。有相關(guān)研究表明,內(nèi)皮祖細胞修復(fù)能力缺陷、血管內(nèi)皮細胞功能障礙和平滑肌細胞功能損傷是血管病變的關(guān)鍵環(huán)節(jié)[1]。細胞膜微囊泡是組織細胞受到來自各種不同的刺激反應(yīng)后釋放的一種直徑約為100-1000nm的細胞膜小囊泡。它在調(diào)節(jié)mi RNA信號轉(zhuǎn)導(dǎo)和功能表達中起非常重要的的作用[2]。按照目前研究結(jié)果的觀點,普遍認為細胞膜微囊泡是miRNAs的主要載體[3]。miRNAs為長度大約18-22個核苷酸的非編碼RNA小分子,它通過抑制蛋白的翻譯或引起mRNA降解,在轉(zhuǎn)錄后的水平上調(diào)控基因表達。miRNAs通過特異信號轉(zhuǎn)導(dǎo),可以調(diào)控細胞周期,對生物的細胞分化、增殖凋亡和激素分泌等生物過程有著極其重要的病理生理學意義。在各種各樣的miRNAs中,很多都與冠心病相關(guān),而miR-155作為炎癥相關(guān)性miRNA,已經(jīng)被證實參與了冠心病血管內(nèi)皮損傷的發(fā)生發(fā)展。本研究主要采取逆轉(zhuǎn)錄熒光定量PCR(qRT-PCR)檢測冠心病患者的血miR-155表達水平,探討miR-155在冠心病發(fā)生發(fā)展中的意義�！狙芯磕康摹刻接懝谛牟』颊叩难獫{細胞微囊泡miR-155的表達水平,了解miR-155與冠心病的相關(guān)性。【研究方法】按照本研究的納入及排除標準收集了2014年1月至2016年12月期間于廣州醫(yī)科大學附屬第二醫(yī)院心血管內(nèi)科住院部92個病例的外周血標本。其中冠心病24例;2型糖尿病21例;冠心病合并糖尿病22例;正常對照組25例。收集這些患者外周血,分離微囊泡,提取血miR-155,采取逆轉(zhuǎn)錄熒光定量PCR,并且收集這些患者的多項一般臨床指標進行分析。本研究的所有數(shù)據(jù)均采用SPSS v16.0軟件進行統(tǒng)計分析。統(tǒng)計方法為單因素方差分析�！窘Y(jié)果】四組患者在性別、年齡、TBIL、DBIL、IBIL、Cr、UA、BNP、LVEF在統(tǒng)計學上無明顯差異(P0.05)。冠心病組患者的CHOL相對正常對照組升高(P0.05),LDL-C相對正常對照組顯著升高(P0.01)。糖尿病組患者的TG、OGTT 2h、HbA1C及LA相對正常對照組升高(P0.05),HDL-C相對正常對照組降低(P0.05),收縮壓與冠心病合并糖尿病組比較有統(tǒng)計學意義(P0.05)。冠心病合并糖尿病組患者的TG、OGTT2h、Hb A1C及LA相對正常對照組升高(P0.05),HDL-C相對正常對照組降低(P0.05)。冠心病組及糖尿病組患者的血漿細胞微囊泡miR-155表達水平與正常對照組有明顯統(tǒng)計學差異(P0.01),冠心病合并糖尿病組患者的血漿細胞微囊泡miR-155表達水平與正常對照組有統(tǒng)計學差異(P0.05)。冠心病組及糖尿病組與冠心病合并糖尿病組比較無統(tǒng)計學意義(P0.05)。【結(jié)論】1.冠心病、糖尿病及冠心病合并糖尿病組患者的血漿細胞膜微囊泡的miR-155表達水平比較一般人群明顯升高。2.冠心病及糖尿病與冠心病合并糖尿病患者的血漿細胞膜微囊泡的miR-155表達水平比較無差異。
[Abstract]:[background] Coronary atherosclerotic heart disease is defined as coronary atherosclerosis, which can lead to coronary artery stenosis or occlusion, resulting in myocardial ischemia. A clinical syndrome caused by hypoxia or necrosis. Related studies have shown that endothelial progenitor cell repair ability defect vascular endothelial cell dysfunction and smooth muscle cell functional damage is the key link of vascular disease [1]. Cell membrane microvesicle is a kind of cell membrane vesicle about 100-1000nm in diameter which is released by different stimuli of tissue cells. It plays a very important role in regulating mi RNA signal transduction and functional expression [2]. According to the viewpoint of current research results, it is generally believed that cell membrane microvesicles are the main carrier of miRNAs [3] .miRNAs are non-coding RNA small molecules with a length of about 18-22 nucleotides, which inhibit the translation of proteins or cause mRNA degradation. Regulating gene expression. MiRNAs through specific signal transduction at post-transcriptional level can regulate cell cycle and play an important role in biological processes such as cell differentiation, proliferation, apoptosis and hormone secretion. Among all kinds of miRNAs, many miRNAs are related to coronary heart disease (CHD), and miR-155, as inflammation related miRNAs, has been proved to be involved in the occurrence and development of coronary artery disease (CHD) vascular endothelial damage. In this study, the expression of miR-155 in blood of patients with coronary heart disease was detected by reverse transcription fluorescence quantitative PCR (qRT-PCR), and the significance of miR-155 in the occurrence and development of coronary heart disease was discussed. [objective] to investigate the expression level of miR-155 in plasma cell microvesicles of patients with coronary heart disease. To understand the correlation between miR-155 and coronary heart disease. According to the inclusion and exclusion criteria of this study, the peripheral blood samples were collected from 92 patients in the Department of Cardiovascular Medicine of the second affiliated Hospital of Guangzhou Medical University from January 2014 to December 2016. There were 24 cases of coronary heart disease with type 2 diabetes, 22 cases of coronary heart disease with diabetes mellitus and 25 cases of normal control group. The peripheral blood was collected, microvesicles were isolated, blood miR-155 was extracted, reverse transcription fluorescence quantitative PCRs were taken, and some general clinical indexes were collected for analysis. All the data were analyzed by SPSS v16.0 software. [results] there was no significant difference in LVEF between the four groups in sex, age and age (P0.05). Chol in coronary heart disease group was higher than that in normal control group (P0.05) and LDL-C was significantly higher than that in normal control group (P0.01). TGG OGTT 2h HbA1C and LA in diabetic group were higher than those in normal control group (P0.05), HDL-C was lower than normal control group (P0.05), systolic blood pressure (SBP) was significantly higher than that in CHD with diabetes group (P0.05). The levels of HbA1C and LA in CHD with diabetes mellitus group were higher than those in normal control group (P0.05) and HDL-C level was lower than that in normal control group (P0.05). The expression of miR-155 in plasma cell microvesicles in coronary heart disease group and diabetic group was significantly different from that in normal control group (P0.01), and the expression level of plasma cell microvesicular miR-155 in coronary heart disease complicated with diabetes group was significantly different from that in normal control group (P0.05). Coronary heart disease group and diabetes group compared with coronary heart disease combined with diabetes group had no statistical significance (P0.05). [conclusion] 1. The expression of miR-155 in plasma membrane microvesicles in patients with coronary heart disease, diabetes mellitus and coronary heart disease with diabetes mellitus was significantly higher than that in the general population. There was no difference in the expression of miR-155 in plasma membrane microvesicles between patients with coronary heart disease (CHD) and diabetes mellitus (DM) and with diabetes mellitus (CHD).
【學位授予單位】：廣州醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R541.4

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