摘要
目的探讨微小RNA-21(miR-21)在心肺复苏(cardiopulmonary resuscitation,CPR)后大鼠血浆中的表达差异及其意义。方法 SD大鼠随机分成假手术对照组(对照组)和心肺复苏组(CPR组),每组16只。采用窒息法建立大鼠心肺复苏模型,测定大鼠气管切开后(对照组)或心肺复苏后(CPR组)24 h的心率(HR)、左室收缩末压(LVESP)、左室舒张末压(LVEDP)、左室内压的最大上升和下降速率(±dp/dtmax)等血流动力学指标。两组于气管切开后(对照组)或心肺复苏后(CPR组)24 h取全血,离心取血浆,提取总miRNA,用实时荧光定量PCR(qRT-PCR)方法检测血浆miR-21含量并分析血浆miR-21在两组中表达的差异。测定CK、CK-MB和cTnⅠ,并分析血浆miR-21与上述指标的相关性。采用计算受试者工作特征(ROC)曲线下面积(AUC)评估miR-21、CK、CK-MB及cTnⅠ诊断CPR后心功能障碍的效能。结果与对照组比较,CPR组大鼠HR、LVSEP、LVEDP、±dp/dtmax及血浆miR-21、CK、CK-MB、cTnⅠ表达差异具有统计学意义(P<0.01)。相关分析表明,CPR后大鼠血浆miR-21的表达量与CK、CK-MB、cTnⅠ和LVEDP呈正相关性,与HR、LVSEP和±dp/dtmax呈负相关(P<0.01)。血浆miR-21、CK、CK-MB和cTnⅠ的曲线下面积分别为0.859、0.719、0.803、1.000。结论miR-21可能参与了CPR后心功能障碍,血浆miR-21可能是CPR后心肌损伤潜在的诊断学标志物。
Objective To investigate the difference of microRNA-21 （miR-21）expression in rat plasma after cardiopulmonary resuscitation（CPR） and its significance. Methods SD rats were randomly divided into sham operation control group（control group）and cardiopulmonary resuscitation group（CPR group）, with 16 rats in each group. The model of cardiopulmonary resuscitation in rats was established by using smothering method. Hemodynamic parameters were measured after tracheotomy（control group） or after cardiopulmonary resuscitation（CPR group）, such as heart rate（HR）, left ventricular end-systolic pressure （LVESP）, left ventricular end-diastolic blood pressure（LVESP）, maximum rise and fall rate of left ventricular pressure （±dp/dtmax） and other hemodynamic parameters. Whole blood was collected 24 h after tracheotomy （control group） or cardiopulmonary resuscitation（CPR group）in both group, the plasma was collected after centrifuge, and total miRNA was extracted. The plasma miR-21 content was measured by real-time fluorescence quantitative PCR （qRT-PCR）and the difference of plasma miR-21 expressions between the two groups was analyzed. CK, CK-MB and cTnI were measured and the correlation between plasma miR-21 and the above indexes were analyzed. The efficacy of miR-21, CK, CK-MB and cTnI in the diagnosis of cardiac dysfunction after CPR was assessed by caI- culating the area under the ROC curve （AUC）. Results Compared with the control group, the differences of expressions of HR, LVSEP, LVEDP, ± dp/dtmax and plasma miR-21, CK, CK-MB and eTnI in CPR group were statistically significant（P〈0.01）. Correlation analysis showed that the expression volume of miR-21 in rat plasma after CPR was positively correlated with CK, CK-MB, cTnI and LVEDP, and negatively correlated with HR, LVSEP and ± dp/dtmax （P〈0.01）. The area under the curves of plasma miR-21, CK, CK-MB and eTnI were 0.859, 0.719, 0.803 and 1.000 respectively. Conclusion miR-21 may be involved in cardiac dysfunction after CPR. Plasma miR-21 may be a potential diagnostic marker for myocardial injury after CPR.
作者
何爱文
王东升
张倩倩
陈寿权
李章平
李惠萍
黄唯佳
程俊彦
HE Aiwen WANG Dongsheng ZHANG Qianqian CHEN Shouquan LI Zhangping LI Huiping HUANG Weijia CHENG Junyan(Department of Emergency,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000, Chin)
出处
《中国现代医生》
2017年第24期37-40,45,F0003,共6页
China Modern Doctor
基金
浙江省自然科学基金项目(LY16H150008)
浙江省温州市科技计划项目(Y20140675)
