环状RNA-CDR1as与急性心肌梗死患者危险分层及梗死后早期室性心律失常的关系

发布时间：2018-05-01 15:21

本文选题：环状RNA + 急性心肌梗死　；参考：《江苏大学》2017年硕士论文

【摘要】：背景:急性心肌梗死(acute myocardial infarction,AMI)是心内科常见急症,是基于冠状动脉病变基础上,突发的冠状动脉血流骤然减少或突然中断,致使缺血部分冠脉所对应的心肌细胞发生严重、持久的缺血,进而造成局部心肌细胞的急性坏死。小脑变性相关蛋白1反义转录物(cerebellardegeneration-relatedprotein1antisense,CDR1as)是由人染色体X的反义链上的CDR1as基因外显子经反相剪切形成的环状RNA(circularRNA,circRNA)。经研究证实CDR1as在急性心肌梗死中有重要作用,但目前未见环状RNA-CDR1as与急性心肌梗死患者危险分层及梗死后早期室性心律失常关系的相关性研究。目的:初步探讨急性心肌梗死(AMI)患者外周循环血液中环状RNA-CDR1as与该患者危险分层及梗死后早期室性心率失常的关系。方法:选取我院2016年1月29日至2016年8月29日,以突发急性胸痛为主要症状入胸痛中心,经严格查体、心脏彩超、血液BNP尤其是心电图、心梗三项确诊为急性心肌梗死患者50例,分别于急诊冠状动脉支架植入术(PCI)术前、术后24h、术后48h抽取患者外周循环血液,为排除其他疾病影响选50名非急性心肌梗死患者作对照,并选取10例健康成人作空白对照,利用基因芯片技术检测外周血液中环状RNA作为筛选试验,以实时定量PCR行验证实验,与此同时对于入选患者进行严格而全面的急性冠脉事件评分(GRACE),并对入选患者行心电监护及完善术后24h动态心电图。结果:1.环状RNA-CDR1as在AMI组中较健康组有明显升高(P0.05),且在疾病早期(PCI术前)即有升高,可稳定存在于术后48h(P0.05);2.环状RNA水平与患者梗死后危险分层相关(P0.05);3.环状RNA水平与患者梗死后室性心律失常明显相关性(P0.05)。结论:环状RNA-CDR1as在急性心肌梗死患者发病早期即可升高,可稳定存在于术后48h,其水平与急性冠脉事件评分(GRACE)呈正相关,因此与患者预后可能具有密切关联。且环状RNA-CDR1as水平与患者梗死后早期室性心律失常相关性明显。
[Abstract]:Background: acute myocardial infarction (AMI) is a common emergency in cardiology. It is based on coronary artery disease. The sudden decrease or sudden interruption of coronary blood flow results in serious myocardial cells corresponding to the ischemic part of coronary artery. Persistent ischemia leads to acute necrosis of local myocardial cells. Cerebellardegeneration-related protein 1 antisense transcriptator CDR1asis a circular RNA-circRNAs formed by reverse shearing of CDR1as gene exons on antisense strand of human chromosome X. It has been confirmed that CDR1as plays an important role in acute myocardial infarction, but there is no correlation between annular RNA-CDR1as and risk stratification and ventricular arrhythmia in the early stage of acute myocardial infarction. Objective: to investigate the relationship between circulating RNA-CDR1as in peripheral blood and risk stratification and ventricular arrhythmia in patients with acute myocardial infarction (AMI). Methods: from January 29, 2016 to August 29, 2016, acute chest pain was selected as the main symptom of chest pain center. After strict physical examination, color Doppler echocardiography, blood BNP, especially electrocardiogram (ECG) were selected. Fifty patients with acute myocardial infarction diagnosed by three items of myocardial infarction were collected peripheral circulation blood before PCI, 24 hours after PCI, 48 hours after operation, respectively. In order to exclude the influence of other diseases, 50 non-acute myocardial infarction patients were selected as control group and 10 healthy adults as blank control. The detection of circular RNA in peripheral blood by gene chip technique was used as screening test, and real-time quantitative PCR was used to verify the results. At the same time, the patients were given strict and comprehensive acute coronary events score (ACAE) and electrocardiogram (ECG) monitoring. The result is 1: 1. Annular RNA-CDR1as was significantly higher in AMI group than that in healthy group, and increased significantly in the early stage of the disease. It could be stable at 48h after operation (P0.05 / 2). The level of annular RNA was correlated with risk stratification after infarction (P 0.05). The level of annular RNA was significantly correlated with ventricular arrhythmias after infarction (P 0.05). Conclusion: cyclic RNA-CDR1as can be increased at the early stage of acute myocardial infarction and can exist steadily at 48 hours after operation. The level of cyclic RNA-CDR1as is positively correlated with the acute coronary event score (ACAE), so it may be closely related to the prognosis of the patients. The level of annular RNA-CDR1as was associated with early ventricular arrhythmia after infarction.
【学位授予单位】：江苏大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22

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