MicroRNA-21与肺动脉高压的相关性研究
发布时间：2019-04-23 11:30
【摘要】：目的:通过比较microRNA-21(miRNA-21,miR-21)表达水平与心导管检查术所测得的临床上常用的肺动脉压力及肺血管阻力指标水平的相关性,探讨miRNA-21与肺动脉高压(pulmonary arterial hypertension,PAH)之间的关系及彼此的相关性,明确miRNA-21在PAH严重程度评估中的应用价值。从而为今后PAH的诊断工作指引一个新的思路。方法:收集2016年11月-2017年03月期间于广西区人民医院心内科住院的患者,所有行心导管检查,并经导管完整行多点测量压力及抽血行血气分析者61例。其中男性20例,女性41例。参照ESC于2015年公布的最新的肺动脉高压诊断指南:患者静息状态,心导管检查术测定的平均肺动脉压力(mPAP)≥25 mmHg进行分组,分为肺动脉压力PAP增高组17例(A组)和肺动脉压力PAP正常组44例(B组)。入院后第二天早晨,留取入组患者肘静脉血液5ml送至广西区人民医院科研实验中心运用Trizol法提取总RNA,反转录得到cDNA,进行实时荧光定量PCR检测,再根据2-△△CT法计算出miRNA-21的相对表达量。收取患者住院期间所有临床基线资料。运用SPSS 20.0软件分析数据,分析miRNA-21在肺动脉高压病变的筛查、严重程度的诊断、预后评价以及治疗后随访的评估中的临床应用价值。结果:(1)A、B两组平均肺动脉压力mPAP分别为(41.24±13.06)mmHg、(19.90±2.41)mmHg,差异存在统计学意义(P0.05);肺血管阻力PVR分别为(4.97±0.91)Wood、(3.40±0.54)Wood,差异存在统计学意义(P0.05);肺血管阻力指数PVRi分别为(7.74±1.18)、(5.28±1.03),差异存在统计学意义(P0.05);肺体循环血流量比值Qp/Qs分别为(1.58±0.42)、(1.31±0.21),差异存在统计学意义(P0.05)。(2)A、B两组miRNA-21相对表达量分别为(5.26±1.06)、(3.69±0.86),差异存在统计学意义(P0.05)。(3)A、B两组患者miRNA-21的表达量与平均肺动脉压力mPAP之间的相关系数为r=0.631(P0.05),且呈线性相关(F=38.947,P0.05);miRNA-21的表达量与肺血管阻力PVR之间的相关系数为r=0.522(P0.05),且呈线性相关(F=22.123,P0.05);miRNA-21表达水平与肺血管阻力指数PVRi之间呈中等程度相关(r=0.503,P0.05),且呈线性相关(F=20.020,P0.05);miRNA-21表达水平与肺体循环血流量比值Qp/Qs之间呈无明显相关性(P=0.165)。结论:肺动脉高压患者miRNA-21的表达水平明显升高,miRNA-21可作为肺动脉高压病变评估及预后评价的指标;
[Abstract]:Objective: to investigate the relationship between the expression of microRNA-21 (miRNA-21,miR-21) and pulmonary arterial pressure and pulmonary vascular resistance (PVR) measured by cardiac catheterization in order to explore the relationship between miRNA-21 and pulmonary hypertension (pulmonary arterial hypertension,). The relationship and correlation between PAH) were used to determine the value of miRNA-21 in PAH severity assessment. So as to guide a new train of thought for the diagnosis of PAH in the future. Methods: 61 patients who were hospitalized in the Department of Cardiology of Guangxi people's Hospital from November 2016 to March 2017 were collected. All patients underwent cardiac catheterization, and 61 patients underwent multipoint pressure measurement and blood gas analysis. There were 20 males and 41 females. According to the latest ESC guidelines for the diagnosis of pulmonary hypertension published in 2015: patients' resting status, the mean pulmonary arterial pressure measured by cardiac catheterization was grouped into groups with a mean pulmonary artery pressure of more than 25 mmHg. They were divided into two groups: group A (17 cases) with increased pulmonary arterial pressure (PAP) and 44 cases (group B) with normal pulmonary arterial pressure (PAP). In the morning after admission, the blood 5ml from the elbow vein of the patients in the group was sent to the scientific research and experiment center of Guangxi people's Hospital by using Trizol method to extract the total RNA, reverse transcription to obtain cDNA, for real-time fluorescence quantitative PCR detection. Then the relative expression of miRNA-21 was calculated by 2-CT method. Receive all clinical baseline data during hospitalization. The clinical value of miRNA-21 in the diagnosis of pulmonary hypertension, the diagnosis of severity, the evaluation of prognosis and the evaluation of follow-up after treatment were analyzed by using SPSS 20.0 software to analyze the clinical application value of miRNA-21 in pulmonary hypertension disease screening, severity diagnosis and prognosis evaluation. Results: (1) the mean pulmonary artery pressure (mPAP) in group A and B was (41.24 卤13.06) mmHg, () 19.90 卤2.41 mmHg, (P0.05). Pulmonary vascular resistance (PVR) was (4.97 卤0.91) Wood, () 3.40 卤0.54 Wood, (P0.05). The pulmonary vascular resistance index (PVRi) was (7.74 卤1.18), (5.28 卤1.03), the difference was statistically significant (P0.05). The ratio of pulmonary systemic blood flow (Qp/Qs) was (1.58 卤0.42), (1.31 卤0.21), the difference was statistically significant (P0.05). (2) A, and the relative expression of miRNA-21 in group B was (5.26 卤1.06), respectively. (3.69 卤0.86), the difference was statistically significant (P0.05). (- 3) A, the correlation coefficient between the expression of miRNA-21 and the mean pulmonary artery pressure mPAP in group B was 0. 631 (P0.05), and there was a linear correlation between the expression and the mean pulmonary artery pressure (mPAP) (F = 38. 947, P < 0. 05). (P 0.05); The correlation coefficient between the expression of miRNA-21 and pulmonary vascular resistance (PVR) was r = 0.522 (P0.05), and there was a linear correlation (F = 22.123, P0.05). There was a moderate correlation between the expression of miRNA-21 and pulmonary vascular resistance index (PVRi) (r = 0.503, P 0.05), and a linear correlation (F = 20.020, P 0.05). There was no significant correlation between the expression of miRNA-21 and the ratio of pulmonary systemic blood flow (Qp/Qs) (P < 0. 165). Conclusion: the expression level of miRNA-21 in patients with pulmonary hypertension is significantly higher, and miRNA-21 can be used as a marker for evaluating the pathological changes of pulmonary hypertension and evaluating the prognosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1
本文编号：2463424
[Abstract]:Objective: to investigate the relationship between the expression of microRNA-21 (miRNA-21,miR-21) and pulmonary arterial pressure and pulmonary vascular resistance (PVR) measured by cardiac catheterization in order to explore the relationship between miRNA-21 and pulmonary hypertension (pulmonary arterial hypertension,). The relationship and correlation between PAH) were used to determine the value of miRNA-21 in PAH severity assessment. So as to guide a new train of thought for the diagnosis of PAH in the future. Methods: 61 patients who were hospitalized in the Department of Cardiology of Guangxi people's Hospital from November 2016 to March 2017 were collected. All patients underwent cardiac catheterization, and 61 patients underwent multipoint pressure measurement and blood gas analysis. There were 20 males and 41 females. According to the latest ESC guidelines for the diagnosis of pulmonary hypertension published in 2015: patients' resting status, the mean pulmonary arterial pressure measured by cardiac catheterization was grouped into groups with a mean pulmonary artery pressure of more than 25 mmHg. They were divided into two groups: group A (17 cases) with increased pulmonary arterial pressure (PAP) and 44 cases (group B) with normal pulmonary arterial pressure (PAP). In the morning after admission, the blood 5ml from the elbow vein of the patients in the group was sent to the scientific research and experiment center of Guangxi people's Hospital by using Trizol method to extract the total RNA, reverse transcription to obtain cDNA, for real-time fluorescence quantitative PCR detection. Then the relative expression of miRNA-21 was calculated by 2-CT method. Receive all clinical baseline data during hospitalization. The clinical value of miRNA-21 in the diagnosis of pulmonary hypertension, the diagnosis of severity, the evaluation of prognosis and the evaluation of follow-up after treatment were analyzed by using SPSS 20.0 software to analyze the clinical application value of miRNA-21 in pulmonary hypertension disease screening, severity diagnosis and prognosis evaluation. Results: (1) the mean pulmonary artery pressure (mPAP) in group A and B was (41.24 卤13.06) mmHg, () 19.90 卤2.41 mmHg, (P0.05). Pulmonary vascular resistance (PVR) was (4.97 卤0.91) Wood, () 3.40 卤0.54 Wood, (P0.05). The pulmonary vascular resistance index (PVRi) was (7.74 卤1.18), (5.28 卤1.03), the difference was statistically significant (P0.05). The ratio of pulmonary systemic blood flow (Qp/Qs) was (1.58 卤0.42), (1.31 卤0.21), the difference was statistically significant (P0.05). (2) A, and the relative expression of miRNA-21 in group B was (5.26 卤1.06), respectively. (3.69 卤0.86), the difference was statistically significant (P0.05). (- 3) A, the correlation coefficient between the expression of miRNA-21 and the mean pulmonary artery pressure mPAP in group B was 0. 631 (P0.05), and there was a linear correlation between the expression and the mean pulmonary artery pressure (mPAP) (F = 38. 947, P < 0. 05). (P 0.05); The correlation coefficient between the expression of miRNA-21 and pulmonary vascular resistance (PVR) was r = 0.522 (P0.05), and there was a linear correlation (F = 22.123, P0.05). There was a moderate correlation between the expression of miRNA-21 and pulmonary vascular resistance index (PVRi) (r = 0.503, P 0.05), and a linear correlation (F = 20.020, P 0.05). There was no significant correlation between the expression of miRNA-21 and the ratio of pulmonary systemic blood flow (Qp/Qs) (P < 0. 165). Conclusion: the expression level of miRNA-21 in patients with pulmonary hypertension is significantly higher, and miRNA-21 can be used as a marker for evaluating the pathological changes of pulmonary hypertension and evaluating the prognosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1
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