miRNA在颈动脉狭窄患者外周血中的动态表达及血管支架植入对其影响的实验研究

发布时间：2018-07-11 09:52

本文选题：miRNA + 颈动脉狭窄　；参考：《西南医科大学》2016年硕士论文

【摘要】：目的:检测并比较颈动脉狭窄患者和对照人群外周血液循环miRNA146a、miR-4284、miR-4463、miR-4306、miR-210、miR-221动态表达水平,探讨其与颈动脉狭窄的关系及血管支架植入对其影响,以及作为颈动脉狭窄诊断标志物的可行性。方法:选取27例已行颈内支架植入术的血管颈动脉狭窄患者,分别在术前2天内、术后24 h内、术后1月,术后3月抽取肘静脉血液,全血提取总RNA,用实时定量PCR(RT-PCR)方法,检测两组外周循环血液中miRNA146a、miRNA4284、miRNA4463、miRNA4306、miRNA210、miRNA221的动态表达量是否有差异;使用SPSS13.0统计软件进行数据的统计分析,计数资料以平均值±标准差(x±S)表示,组间均数比较采用t检验,采用单因素方差分析完成多个样本均值之间的比较,率的比较采取卡方检验,P0.05认为差异具有统计学意义,每次检验重复不低于3次。结果:与对照相比,(1)颈动脉狭窄患者颈内支架植入术前血液中miRNA146a上升5.48倍、miRNA4284上升13.83倍、miRNA4463上升23.37倍、miRNA4306上升21.02倍、miRNA210上升3.87倍、miRNA221上升3.05倍,P值均0.05,(2)颈内支架植入术后24h时miRNA146a进一步上升至14.17倍、miRNA4284进一步上升至41.66倍、miRNA210进一步上升至9.39倍、miRNA221进一步上升至19.07倍,而miRNA4463和miRNA4306表达分别下降至4.02和17.17倍,与对照相比差异具有统计学意义(P0.05),(3)颈内支架植入术后1月时,mirna146a降低至对照组的11.26倍、mirna4284降低至对照组的6.17倍、mirna4463降低至对照组的2.5倍、mirna4306降低至对照组的13.39倍、mirna210分别降低至对照组的3.03倍,p值均0.05,而mir-221表达水平与对照无显著差异(p0.05),(4)颈内支架植入术后3月时mirna146a重新回升至对照组的12.85倍、mirna4284重新回升至对照组的27.00倍、mirna4463重新回升至对照组的108.47倍、mirna4306重新回升至对照组的35.20倍、mirna210重新回升至对照组的24.48倍,以上差异均具有统计学意义(p值均0.05),在颈动脉支架手术前术后的比较中,(1)颈动脉狭窄患者血浆中,mir-221的表达显著上升(p0.05),其在支架植入术前、术后24h、术后随访1月、术后随访3月表达均有统计学意义(p0.05);(2)mir-210在支架植入术前、术后24h、术后随访3月表达有统计学意义(p0.05);但术前与术后1月比较时比较无统计学意义(p0.05);(3)mir-4284术后3月与术前、与术后24h、术后1月比较时表达均有统计学意义(p0.05);(4)mir-4306术后1月与术后3月比较时表达有统计学意义(p0.05),余均无统计学意义(p0.05);(5)mir-4463术后3月表达有统计学意义(p0.05),余均无统计学意义(p0.05);(6)mirna146a表达均无明显统计学意义(p0.05)。结论:(1)mirna146a、mirna4284、mirna4463、mirna4306、mirna210、mirna221可能参与了颈动脉狭窄的形成过程,并在颈动脉支架置入术后的病理生理过程中发挥作用,提示其有望成为临床早期诊断颈动脉狭窄的生物学标志,并作为颈动脉狭窄患者发病和病情进展的新型标志物;(2)mir-4463在术后3月变化明显,其高表达可能与支架植入术后慢性期血管重塑再狭窄有关,可能成为一个远期预测再狭窄的新型标志物,但由于样本量较小,需扩大样本量以进一步证实。
[Abstract]:Objective: to detect and compare the dynamic expression of miRNA146a, miR-4284, miR-4463, miR-4306, miR-210, miR-221 in the peripheral blood circulation of patients with carotid stenosis and control, and to explore the relationship between the carotid stenosis and the carotid stenosis and the effect of stent implantation, as well as the feasibility of the diagnostic marker of carotid stenosis. Methods: 27 cases have been selected. The patients with carotid artery stenosis with internal stent implantation were within 2 days before operation, 24 h after operation, the blood was extracted from the elbow vein in January, and the total RNA was extracted in the whole blood, and the real-time quantitative PCR (RT-PCR) method was used to detect the dynamic expression of miRNA146a, miRNA4284, miRNA4463, miRNA4306, miRNA210, miRNA221 in the two groups of peripheral circulation blood. Difference; using SPSS13.0 statistical software to carry out statistical analysis of data, the count data is expressed with mean mean standard deviation (x + S), and the average number of groups is compared with t test. The comparison of the mean values of multiple samples is completed by single factor analysis of variance. The comparison of rate is taken by chi square test. P0.05 believes that the difference is statistically significant, and each test repeats is not repeated. Results below 3 times. Results: (1) miRNA146a increased 5.48 times in blood before carotid artery stent implantation in patients with carotid artery stenosis, miRNA4284 increased 13.83 times, miRNA4463 increased 23.37 times, miRNA4306 increased 21.02 times, miRNA210 increased 3.87 times, miRNA221 increased 3.05 times, P value was 0.05, and miRNA146a further increased after internal carotid stent implantation (2). To 14.17 times, miRNA4284 increased further to 41.66 times, miRNA210 further increased to 9.39 times, miRNA221 further increased to 19.07 times, while miRNA4463 and miRNA4306 decreased to 4.02 and 17.17 times respectively, compared with the control (P0.05), (3) mirna146a decreased to 11.26 of the control group in January after the stent implantation. Mirna4284 decreased to 6.17 times of the control group, mirna4463 decreased to 2.5 times of the control group, mirna4306 decreased to 13.39 times of the control group, mirna210 decreased to 3.03 times of the control group, P value was 0.05, and the miR-221 expression level was not significantly different from the control (P0.05), and (4) the mirna146a recovered to 12 of the control group in March after the internal stent implantation. .85 times, mirna4284 recovered 27 times to the control group, and mirna4463 recovered to 108.47 times as much as the control group. Mirna4306 again recovered to 35.20 times of the control group, and mirna210 recovered to 24.48 times of the control group. The above differences were statistically significant (P value 0.05), and (1) carotid stenosis in the preoperative and postoperative comparison of carotid artery stents. In the plasma of narrow patients, the expression of miR-221 was significantly increased (P0.05). Before stent implantation, postoperative 24h, postoperative follow-up and follow-up in March were statistically significant (P0.05). (2) mir-210 before stent implantation, postoperative 24h, postoperative follow-up was statistically significant (P0.05), but there was no statistical difference between preoperative and January after the operation. Significance (P0.05); (3) the expression of mir-4284 was statistically significant (P0.05) in March and before operation, compared with postoperative 24h and postoperative January; (4) there was statistical significance (P0.05) in January and March after mir-4306 operation (P0.05); (5) there was statistical significance (P0.05) in March after operation (P0), and there was no statistical significance (P0). .05); (6) there is no significant statistical significance in mirna146a expression (P0.05). Conclusion: (1) mirna146a, mirna4284, mirna4463, mirna4306, mirna210, mirna221 may be involved in the formation of carotid stenosis and play a role in the pathophysiological process of carotid artery stenting, suggesting that it is expected to be a clinical early diagnosis of carotid stenosis. Biological markers and as a new marker for the onset and progression of patients with carotid stenosis; (2) mir-4463 changes in March after operation, and its high expression may be associated with chronic vascular restenosis after stent implantation, which may be a new marker for long-term prediction of restenosis. However, it is necessary to expand the sample size due to the small sample size. The amount is further confirmed.
【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R651.12

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