人外周血cTnI-mRNA对心肌微小损伤的诊断价值  

Diagnositic Values of Circulating Cardial Troponin I Messager RNA for Patients with Myocardial Minuteness Damage

作　　者：朱健华[1] 姚登福[1] 高增栋[1] 吴玮[1] 吴信华[1] 邱历伟[1] 

机构地区：[1]江苏省南通医学院附属医院,南通226001

出　　处：《中国临床医学》2004年第5期701-703,共3页Chinese Journal of Clinical Medicine

基　　金：江苏省自然科学基金项目资助 (№BK99160 )

摘　　要：目的 :探讨外周血心肌肌钙蛋白I(cTnI) -mRNA对心肌损伤诊断的临床价值。方法 :以电镜观察心肌损伤时的超微结构改变 ,并从心肌组织和外周血中制备总mRNA ,经随机引物和逆转录酶作用合成cTnI -cDNA ,再分别以巢式PCR扩增cTnI-cDNA片段 ,并与心肌酶谱 (CK、CK -MB、AST、LDH)及cTnI定性进行比较 ,分析其在心肌损伤中的临床价值。结果 :心肌损伤组织超微结构表现为心肌线粒体肿胀、嵴断裂、严重空泡样变及细胞核异形变、染色质浓缩边聚。巢式PCR扩增cTnI-mRNA片段的灵敏度为 2 pg/μl,cTnI -mRNA存在于血浆而非有核细胞 ;6 2例心脏病患者中cTnI -mRNA阳性 2 0例 ,明显高于酶学检测和cTnI定性 (P <0 .0 5 )。结论 :资料提示cTnI-mRNA存在于外周血浆 ,外周血cTnI-mRNA检测对心肌损伤诊断具有更高的敏感性。Objective: To evaluate the clinical values of peripheral blood myocardial troponin I (cTnI) messager RNA(MRNA) in diagnosis of patients with myocardial damage. Methods: Microstructure of damage myocardial cell was examined by electron microscopy. The cTnI-mRNAs were extracted from human heart tissue and peripheral blood and synthesized to cTnI-cDNA through random primers and reverse transcriptase, amplified by a nested polymerase chain reaction assay, and the clinical values of cTnI-mRNA were analyzed and compared with serum levels of CK, CK-MB, AST, LDH, and cTnI in patients with myocardial diseases. Results: Microstructure of cardiac myocytes with mitochondrial swell and rupture, severity vacancy-like denatureation and nucleus abnormality, chromatin condensed and borders were observed by electron microscopy. The sensitivity of RT-PCR was 2pg/μl for cTnI-mRNA analysis, and cTnI-mRNA was in blood plasma and not in nucleus cell. The incidence of cTnI-mRNA was significantly higher than those of enzymatic patterns and blood cTnI (P<0.05) in 62 patients with heart diseases. Conclusion:The present data suggested that cTnI- mRNA in circulating blood is a sensitive marker than enrymatic patterns or serum cTnI protein in diagnosis of myocardial minuteness damagte.

关 键 词：心肌损伤 RNA 人外周血 诊断价值 临床价值 血浆 巢式PCR 扩增 定性 目的 

分 类 号：R542[医药卫生—心血管疾病] R512[医药卫生—内科学]