【摘要】：目的：心房顫動(房顫)是最常見的心律失常,如發(fā)生在無器質(zhì)性心臟病變者,則稱為孤立性房顫,其相關(guān)研究較少。臨床檢查雖未見明顯的心臟結(jié)構(gòu)及運動異常,但可能已經(jīng)存在輕微的結(jié)構(gòu)和功能改變。MicroRNA-21 (miRNA-21)是新近發(fā)現(xiàn)的與心臟結(jié)構(gòu)重構(gòu)密切相關(guān)的小分子RNA。目前孤立性房顫與血漿miRNA-21水平關(guān)系的研究尚未見報道。本實驗旨在通過研究孤立性房顫患者血漿miRNA-21水平,初步探討血漿miRNA-21與孤立性房顫的相關(guān)性,闡述miRNA-21在孤立性房顫診斷中的價值。方法：連續(xù)收集2013年6月至2015年1月于我院心內(nèi)科確診為孤立性房顫,其中孤立性房顫組又分成陣發(fā)性房顫、持續(xù)性房顫兩個亞組。健康對照組23例為來自門診體檢的健康人。所有患者均于清晨空腹靜息狀態(tài)下,肘靜脈抽血后,提取血漿總RNA,質(zhì)量鑒定后,進(jìn)行逆轉(zhuǎn)錄,qRT-PCR技術(shù)測量血漿miRNA-21的水平。數(shù)據(jù)統(tǒng)計學(xué)分析采用SPSS18.0軟件進(jìn)行。結(jié)果：1、健康對照組血漿miRNA-21相對表達(dá)量(2-△△Ct)為1.13±0.57,而孤立性房顫組血漿miRNA-21相對表達(dá)量為1.88±0.77,差異有統(tǒng)計學(xué)意義(P0.01)；2、陣發(fā)性房顫和持續(xù)性房顫兩個亞組,血漿miRNA-21相對表達(dá)量分別為1.49±0.61和2.19±0.76。其中陣發(fā)性房顫組miRNA-21較健康對照組有略微升高趨勢,但無統(tǒng)計學(xué)意義(P0.05)；而持續(xù)房顫組miRNA-21明顯高于健康對照組,差異有統(tǒng)計學(xué)意義(P0.001)；而且也高于陣發(fā)性房顫組,差異具有統(tǒng)計學(xué)意義(P0.01)結(jié)論：1、孤立性房顫血漿miRNA-21表達(dá)量較健康對照組明顯升高,提示miRNA-21可能參與房顫的發(fā)生和維持,孤立性房顫存在心房結(jié)構(gòu)重構(gòu)；2、持續(xù)性房顫患者血漿miRNA-21表達(dá)量明顯高于健康對照及陣發(fā)性房顫患者,‘而陣發(fā)性房顫miRNA-21表達(dá)相對于健康對照組無明顯升高,提示miRNA-21的表達(dá)可能跟房顫發(fā)作的嚴(yán)重程度密切相關(guān)；3、miRNA-21可用作評價孤立性房顫病情嚴(yán)重程度及預(yù)后的客觀生物標(biāo)志物。
[Abstract]:Objective: atrial fibrillation (AF) is the most common arrhythmia. Although there is no obvious abnormality of cardiac structure and movement in clinical examination, there may already be slight structural and functional changes. MicroRNA-21 (miRNA-21) is a newly discovered small molecule RNA which is closely related to cardiac structural remodeling. The relationship between isolated atrial fibrillation and plasma miRNA-21 levels has not been reported. The aim of this study was to study the level of miRNA-21 in plasma of patients with isolated atrial fibrillation, and to explore the relationship between miRNA-21 and isolated atrial fibrillation, and to elucidate the value of miRNA-21 in the diagnosis of isolated atrial fibrillation. Methods: isolated atrial fibrillation was diagnosed in our hospital from June 2013 to January 2015. The isolated atrial fibrillation group was divided into two subgroups: paroxysmal atrial fibrillation and persistent atrial fibrillation. The healthy control group consisted of 23 healthy persons from outpatient examination. Plasma total RNAs were extracted from all patients at fasting resting state in the morning after cubital vein blood sampling. After quality identification, the level of miRNA-21 in plasma was measured by reverse transcription qRT-PCR. The data were analyzed by SPSS 18.0 software. Results the relative expression of miRNA-21 was 1.13 鹵0.57 in healthy control group and 1.88 鹵0.77 in isolated atrial fibrillation group. The difference was statistically significant (P0.01). There were two subgroups of paroxysmal atrial fibrillation and persistent atrial fibrillation. The relative expression levels of miRNA-21 in plasma were 1.49 鹵0.61 and 2.19 鹵0.76, respectively. The miRNA-21 in paroxysmal atrial fibrillation group was slightly higher than that in the healthy control group, but had no statistical significance (P0.05), while the miRNA-21 level in the persistent atrial fibrillation group was significantly higher than that in the healthy control group (P0.001), and was also higher than that in the paroxysmal atrial fibrillation group. The difference was statistically significant (P0.01). Conclusion the expression of miRNA-21 in isolated atrial fibrillation plasma is significantly higher than that in healthy control group (P0.01), suggesting that miRNA-21 may be involved in the occurrence and maintenance of atrial fibrillation, and isolated atrial fibrillation has atrial structural remodeling. 2. The expression of miRNA-21 in patients with persistent atrial fibrillation was significantly higher than that in healthy controls and patients with paroxysmal atrial fibrillation, but the expression of miRNA-21 in patients with paroxysmal atrial fibrillation was not significantly higher than that in healthy controls. It is suggested that miRNA-21 expression may be closely related to the severity of atrial fibrillation attack. MiRNA-21 may be used as an objective biomarker for evaluating the severity and prognosis of isolated atrial fibrillation.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R541.75

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