摘要
目的探讨血浆可溶性血管细胞黏附分子-1(sVCAM-1)水平和内皮型一氧化氮合酶(eNOS)mRNA的表达在风湿性心脏病(rheumatic heart disease,RHD)伴房颤患者心内血栓形成中的临床应用。方法收集2015年7月～2018年7月在陕西省商洛市中心医院心内科住院治疗的58例RHD患者的血液及临床资料进行回顾性分析,依据是否有心内血栓形成分为血栓组(28例)和无血栓组(30例)。采用实时逆转录-聚合酶链反应(RT-PCR)技术检测血浆eNOSmRNA的表达,采用酶联免疫吸附法检测血浆sVcAM-1水平。同时建立健康对照组(33例),比较分析以上指标的变化与RHD心内血栓形成的关系。结果血浆eNOSmRNA在血栓组、无血栓组和对照组中的表达分别为0.21±0.05,0.49±0.13和0.99±0.27;而血浆sVCAM-1在三组中的水平则分别为11.3±5.2,7.7±3.5和3.7±2.1 ng/L。与对照组比较,血浆sVCAM-1水平在血栓组和无血栓组中显著上调,而eNOSmRNA的表达则显著下调,其中血栓组两标志物的表达上调或下调更显著,以上结果的比较差异均有统计学意义(t=15.29～43.23,均P<0.01)。左房内径(LAD),D-二聚体(D-D)和收缩压(SBP)在血栓组、无血栓组和对照组中的结果分别为55.3±3.2,45.9±2.7和36.3±2.9 mm,2.83±0.67,1.67±0.32和0.35±0.19 mg/L,126.1±8.3,124.9±8.9和124.5±8.7 mmHg。血栓组和无血栓组的左房内径与对照组比较明显增大,血栓组增大更显著。血栓组和无血栓组的D-D水平高于对照组,其中血栓组D-D水平增高更显著。以上结果比较的差异均有统计学意义(t=9.67～37.97,均P<0.01)。各组间SBP的比较差异均无统计学意义(t=0.65～1.13,均P>0.05)。在血栓组和无血栓组中,sVCAM-1和eNOSmRNA分别与D-D水平和LAD具有相关性(r=0.839,-0.829,P<0.01),(r=0.799,-0.782,P<0.01)。sVCAM-1和eNOSmRNA诊断血栓形成的敏感度和特异度分别为70.3%和81.5%,77.3%和85.7%。以血栓组和无血栓组为因变量,sVCAM-1和eNOSmRNA的AUC分别为0.853(95%CI
Objective To investigate the clinical application of plasma sVCAM-1 levels and eNOSmRNA expression in thrombosis of rheumatic heart disease(RHD)with atrial fibrillation.Methods The blood and clinical data of 58 patients with(RHD)hospitalized in the department of cardiology from Shangluo Central Hospital,Shaanxi Province between July 2015 and July 2018 were retrospectively analyzed.They were divided into thrombosis group(28 cases)and non-thrombosis group(30 cases)according to whether there was intracardiac thrombosis.The levels of plasma sVCAM-1 and eNOSmRNA were detected by the methods of ELISA and PT-PCR.At the same time,a healthy control group(33 cases)was established to compare and analyze the relationship between the changes of the above indicators and intracardiac thrombosis in(RHD).Results The plasma expression of eNOSmRNA in thrombosis group,non-thrombosis group and control group were 0.21±0.05,0.49±0.13 and 0.99±0.27,respectively,while the plasma level of sVCAM-1 in three groups was 11.3±5.2,7.7±3.5 and 3.7±2.1 ng/L,respectively.Compared with the control group,the plasma sVCAM-1 level was significantly increased whereas the expression of eNOSmRNA was significantly decreased in thrombosis group and non-thrombosis group.Further,the expression of the two markers was more significant in thrombosis group,and the differences were statistically significant(t=15.29-43.23,all P<0.01).The results of left atrial diameter(LAD),D-dimer(D-D)and systolic blood pressure(SBP)in thrombosis group,non-thrombosis group and control group were 55.3±3.2,45.9±2.7 and 36.3±2.9 mm,2.83±0.67,1.67±0.32 and 0.35±0.19 mg/L,126.1±8.32 124.9±8.9 and 124.5±8.7 mmHg,respectively.Compared with the control group,the diameter of left atrium inthrombosis group and non-thrombosis group increased significantly,especially in thrombosis group.D-D level of thrombosis group and non-thrombosis group was significantly higher than that of control group,and that of thrombosis group was more significant There were significant differences i
作者
张萍
杨静
ZHANG Ping;YANG Jing(Department of Clinical Laboratory,Shangluo Central Hospital,Shaanxi Shangluo 726000,China)
出处
《现代检验医学杂志》
CAS
2019年第2期27-31,共5页
Journal of Modern Laboratory Medicine
