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分子血检能诊断缺血性脑卒中

By Xu Peng, Chief Editor 许鹏 副主编
Posted on 26 Oct 2017
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图片:科研人员已发现血液中的某些生物标记物有望作为一项新检验方法的靶体,诊断最近的缺血性脑卒中(图片MNT).
图片:科研人员已发现血液中的某些生物标记物有望作为一项新检验方法的靶体,诊断最近的缺血性脑卒中(图片MNT).
缺血性脑卒中是最常见、最致命的脑卒中,起因是大动脉内的斑块内容破裂迸出,形成凝血块,阻断流向脑的血流。

迅速确定患者是否有脑卒中至关重要,因为必须在几小时内施行治疗,击碎凝血块,以逆转损害,提高完全恢复的几率。目前没有一种血检方法能诊断脑卒中或识别哪些心血管疾病患者马上发生脑卒中的风险最高。

美国路易斯安那州新奥尔良市Ochsner医疗中心的科学家及其同行比较了血液中非编码核糖核酸(RNA)的水平,这些分子调控五日内发生脑卒中的患者的基因表达,五天多以前,他们中有些人有过脑卒中,有些人没有。科学家测量了接受颈动脉内膜切除术的24名无症状患者和17名急性症状患者(前五日内急性缺血性脑血管事件)血清中微RNAs、miR-221、miR-222、miR-145和环状RNA (circR)-284的水平。

研究人员发现,急性患者血清中的miR-221水平远远低于无症状患者,而circR-284水平高于无症状患者。急性患者血清circR-284: miR-221的比值显著升高,表现出作为指示颈动脉斑块破裂和脑卒中的生物标记物的有利特性。一项确证研究招募了112名患者(47名无症状患者,41名急性患者,24名颈动脉内膜切除术后5天到180天之间发生脑血管事件的患者),证实只有急性组的血清circR-284:miR-221比升高,且灵敏度和特异性足以检测斑块破裂和脑卒中。

该研究的论文发表于2017年8月4日的《血液循环:心血管遗传学》(Circulation: Cardiovascular Genetics)杂志。作者总结说,血清circR-284: miR-221比有望成为诊断斑块破裂和脑卒中的生物标记物。此外,他们还演示了用功能相关的循环非编码RNA对作为心血管疾病的生物标记物。领衔作者、外科助理教授Hernan A. Bazan大夫说:“这项工作代表着朝理解与预测颈动脉相关脑卒中迈出的重要一步。我们正通过像这样的转化研究开发更好的疗法,并致力于预防这些疾病的发作。”

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