小儿先心病相关肺动脉高压血清BNP及microRNA的临床研究

发布时间：2018-04-22 04:30

本文选题：小儿先心病 + 肺动脉高压　；参考：《北京协和医学院》2016年硕士论文

【摘要】：目的：通过探索小儿先心病肺动脉高压(pulmonary arterial hypertension,PAH)患者血清脑利尿肽(brain natriuretic factor or peptide,BNP)的浓度和microRNA (miRNA)的表达水平,研究它们与PAH的关系及彼此之间的相关性,从而为先心病肺动脉高压的诊断提供帮助。方法：收集泰达国际心血管病医院2015年10月至2016年4月收治确诊为先天性心脏病患者39例。其中男性21例,女性18例。根据2008年肺动脉高压国际论坛会公布的肺动脉高压的诊断标准进行分组,分别为先天性心脏病肺动脉压力正常组16例(A组)；先天性心脏病合并轻、中度肺动脉高压组(B组)15例和先天性心脏病重度动脉高压组(c组)8例。采集受试者外周静脉血,利用BNP免疫反应试剂盒对血清BNP浓度进行检测；同时利用实时定量PCR对miRNA表达量进行测定。利用SPSS软件对数据进行ANOVA分析,并做ROC曲线,同时利用Person相关性分析BNP与miRNA共同诊断PAH的合同效果。结果：(1)对受试者血清BNP浓度进行检测,结果显示,先心病肺高压重度患者血清BNP浓度为183.35±6.36,明显高于有先心病但肺动脉血压正常组(p0.01)。(2)肺动脉重度患者miRNA19a表达量为3.28±0.26,显著高于A、B组。ROC曲线下方面积为0.906.(3) BNP与miRNA-19a之间的相关性为0.778,具有统计学差异。结论：1小儿先心病肺动脉高压患者血清BNP浓度可以作为临床诊断指标2.miRNA-19a在先心病肺动脉早期表达量都有所增加,可作为早期预警指标。3.BNP浓度和miRNA-19a的相关性较高,可以协同作用,提高确诊率。
[Abstract]:Objective: to investigate the serum concentration of brain natriuretic factor or microRNA miRNAs in children with pulmonary arterial hypertensionation of congenital heart disease, and to study the relationship between PAH and serum brain natriuretic factor or microRNA miRNAs. It is helpful for the diagnosis of pulmonary hypertension of congenital heart disease. Methods: 39 patients with congenital heart disease were collected from October 2015 to April 2016 in Teda International Cardiovascular Hospital. There were 21 males and 18 females. According to the diagnostic criteria of pulmonary hypertension published by the International Forum on Pulmonary Hypertension in 2008, 16 patients with congenital heart disease with normal pulmonary artery pressure were divided into two groups: group A, congenital heart disease complicated with mild heart disease, 15 cases in group B of moderate pulmonary hypertension and 8 cases in group C of severe congenital heart disease. The peripheral venous blood was collected and the serum BNP concentration was detected by BNP immunoassay kit, and the expression of miRNA was measured by real-time quantitative PCR. The SPSS software is used to analyze the data by ANOVA, and the ROC curve is made. At the same time, the Person correlation analysis is used to analyze the contract effect of BNP and miRNA in the diagnosis of PAH. Results the serum BNP concentration of the subjects was measured and the results showed that, The level of serum BNP in patients with severe pulmonary hypertension was 183.35 卤6.36, which was significantly higher than that in patients with CHD but normal pulmonary blood pressure (P 0.01). The expression of miRNA19a in patients with severe pulmonary artery was 3.28 卤0.26, which was significantly higher than that in group A B, where the area under the curve was 0.906.63) between BNP and miRNA-19a. The correlation was 0.778, with statistical difference. Conclusion the serum BNP concentration in children with congenital heart disease and pulmonary hypertension can be used as a clinical diagnostic index to increase the expression of 2.miRNA-19a in the early stage of pulmonary artery disease, and it can be used as an early warning index. 3. The correlation between the concentration of BNP and miRNA-19a is relatively high, and it can be used as a synergistic index. Increase the rate of diagnosis.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R725.4

【相似文献】