不明原因性心源性猝死者心肌房SCN5A和ANK2的表达及临床意义  

Expression and Clinical Significance of SCN5A and ANK2 in Myocardial Room of Patients with Unexplained Sudden Cardiac Death

作　　者：何崇辉[1,2] 金鑫[1,2] 张有猛[1,2] 肖应林[1,2] 

机构地区：[1]深圳市龙华新区中心医院 [2]广东医学院附属观澜医院全科医学科,广东深圳518110

出　　处：《临床医学工程》2015年第6期716-717,720,共3页Clinical Medicine & Engineering

摘　　要：目的探讨不明原因性心源性猝死（USCD）病患心肌房SCN5A和ANK2的表达状况及临床意义。方法选取2012年1月至2013年12月我院接收的不明原因性心源性猝死病患73例为观察组,随机选取同时间段排除心脏原因死亡的病患50例作为对照组,统计所有USCD病患的概况,对比两组SCN5A和ANK2基因突变比例,记录应用SCN5A、ANK2检测的阳性预测值、准确度等,并对比两组酶学检测指标。结果 USCD病患中心重多为300～400 g,死亡诱因多为纠纷及厮打,猝死表现多为呻吟和抽搐,发病至死亡时间多〈24 h。观察组SCN5A、ANK2的阳性结果出现（-）的病患明显高于对照组,出现（＋）的病患明显低于对照组,差异均有统计学意义（P〈0.05）。应用SCN5A、ANK2进行检测的阳性预测值分别为87.50%和88.89%,且准确度、特异性、敏感性均较高。观察组CK、CK-MB、LDH以及HBDH等指标水平均高于对照组,差异有统计学意义（P〈0.05）。结论 USCD者出现SCN5A和ANK2的比例较高,在应用于检测时的阳性预测值与准确度均较高。因此,USCD病患心肌房SCN5A和ANK2的表达可以作为判断的辅助依据,具有较高的临床价值。Objective To explore the expression status and clinical significance of SCN5 A and ANK2 in myocardial room of patients with unexplained sudden cardiac death（USCD）. Methods 73 cases of USCD patients accepted in our hospital from January 2012 to December 2013 were set as observation group, 50 cases of dead patients excluded cardiac causes at the same time period were set as control group. The conditions of USCD patients were counted, the gene mutation ratio of SCN5 A and ANK2 in two groups was compared, the positive predictive value, accuracy rate by the application of SCN5 A and ANK2 were recorded, the enzymatic detection indexes of two groups were compared. Results The heart weight of USCD patients was 300 ～ 400 g, the main cause of death was disputes and tussle, the sudden death mostly presented groan and convulsions, the time from onset to death was mostly 〈24 h. The positive results of SCN5 A, ANK2 of patients presented（-） in observation group were higher than those in control group, patients presented（＋） were lower than those in control group, all the difference was statistical（P〈0.05）. The positive predictive value of SCN5 A and ANK2 were 87.50% and 88.89% respectively,and the accuracy rate, specificity and sensibility were high. The levels of CK, CK-MB, LDH, HBDH in observation group were higher than those of control group, with statistical difference（P〈0.05）. Conclusions The proportion of SCN5 A and ANK2 in USCD patients is high.The positive predictive value and accuracy rate are high when using SCN5 A and ANK2 for detection. Therefore, the expression of SCN5 A and ANK2 in myocardial room of USCD patients can be used as auxiliary basis for judgment, which has high clinical value.

关 键 词：不明原因性心源性猝死 SCN5A ANK2 表达意义 

分 类 号：R541.78[医药卫生—心血管疾病]