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用基于基因生物标记物的血检检测房颤

By LabMedica International staff writers
Posted on 30 Nov 2014
心脏病研究人员开发了一种基于DNA的血检,以识别房颤患者并预测缺血性脑卒中的几率。

房颤(AF)是最常见的异常心律。它可能不引起症状,但往往与心悸、昏迷、胸痛或充血性心力衰竭有关。一个人房颤的起因可能不明。房颤患者的脑卒中风险将增加四倍。在临床上测脉搏有可能发现房颤,如果心电图(ECG)上P波缺失且心室心率不规则,则可进一步证实存在房颤。房颤可能间歇性发作,每次持续几分钟或几天,也可能终生伴随。许多病症会增加房颤风险,尤其是二尖瓣狭窄。

瑞典隆德大学的研究人员探查了用基因生物标记物检测房颤的可能性。为此他们基于人类基因组中与房颤风险升高有关的12种基因变异(单核苷酸多态性,SNP)建立了房颤基因风险评分(AF-GRS)。

研究人员评估了参与Malmö饮食与癌症研究的27,471名患者的样本,以评估AF-GRS与阵发性房颤和缺血性脑卒中的关联;Malmö饮食与癌症研究是一项立足社区的前瞻性队列研究。阵发性房颤随访期的中值是14.4年,缺血性脑卒中随访期的中值是14.5年。

在随访期间,2160名参与者首次出现房颤事件,1495名参与者首次出现缺血性脑卒中事件。AF-GRS评分前20%的参与者相较后20%的参与者阵发性房颤和缺血性脑卒中的风险有所升高。已确诊为房颤且携带12种SNP的患者脑卒中风险又增加了70%–80%。

该研究的论文发表于2014年10月号的《脑卒中》(Stroke)杂志。资深作者、隆德大学内科学教授Olle Melander博士说:“五分之一的人有基因缺陷,这意味着他们得房颤的风险是基因风险低者的两倍。因此这种基因风险是无明显心脏病的人最强烈的房颤风险因子之一。它像高血压一样使风险升高。对于疑似有暂时房颤复发的患者或者高血压患者来说,医生有必要用血液检验检查他们的基因先天条件。血液检验能提示房颤筛查的频度和强度。我们还考虑对房颤基因风险高的人进行更全面的高血压治疗。”

Related Links:
隆德大学

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