心脏病理多复杂自身免疫生物学标志物的诊断和预后作用

Elvira D. Lovochkina
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引用次数: 0

摘要

的相关性。尽管心血管疾病的生物标志物有很多,但并非所有的生物标志物都具有基于证据的有效性和独立的预后价值。与评估传统方法相比,实验室诊断血清心脏特异性自身抗体诊断心肌细胞损伤具有几个潜在的优势。其中包括对天然球蛋白、肌钙蛋白I (cTnI)、α -肌动蛋白1 (ACTC1)、β -肌球蛋白7B重链(MUN7B)的分析,这些球蛋白是基于对心肌自身抗原的自我维持免疫反应,从而导致表达它们的细胞受损。目的:探讨心肌细胞蛋白、肌钙蛋白I、α -a肌动蛋白1和β -肌球蛋白7B重链自身抗体复合物定量指标对心脏病变患者的诊断价值和实用价值。材料与方法。采用实验室酶免疫分析法对斯塔夫罗波尔地区临床心脏病诊所住院治疗的心脏病患者血清中cTnI、ACTC1和MUN7B自身抗体进行了研究。此外,根据俄罗斯心脏病学会心血管外科医生协会制定的临床建议,并经俄罗斯联邦卫生部科学和实践委员会批准,进行了仪器和实验室检查。这项工作得到了北高加索联邦大学伦理委员会的审查和批准。结果和讨论。血清cTnI、ACTC1、MUN7B蛋白自身抗体水平变化均有统计学意义(p < 0.01 vs . p < 0.01)。当实验室分析的其他标准在可接受的范围内,这决定了其诊断和证据有效性时,在确认心脏病理的个体中,发现cTnI抗体水平持续增加2.36 ng/ml (694.11%), ACTC1抗体水平持续增加3.6 ng/ml (141.73%), MUN7B抗体水平持续增加1.74 ng/ml(119.17%)。结论。本研究结果显示心脏病变患者心脏特异性auto-A - T对心肌细胞蛋白(Anti- ctni, Anti- ACTC1, Anti- m - YH7B)活性变化的关系,不仅提示全身性膜疾病(膜病),而且为心肌细胞直接化学变化提供了令人信服的证据。心肌坏死和缺血标志物与自身免疫球蛋白Anti- ctni、Anti- ACTC1、Anti- myh7b之间也存在相关性,证实了本实验室分析的诊断和实用价值。
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Diagnostic and prognostic role of cardiac pathology multicomplex autoimmune biological markers
Relevance . Despite the large list of biological markers of cardiovascular diseases, not all have evidence-b ased effectiveness and independent prognostic value. Laboratory diagnostics of serum cardiospecific auto-antibodies for the diagnosis of myocyte cell damage has several potential advantages compared to the evaluation of traditional methods. These include the analysis of natural globulins to troponin I (cTnI), to alpha-a ctin 1 (ACTC1), to the heavy chain of beta-myosin 7B (MUN7B), which are based on a self-sustaining immune response to the myocardium’s own auto-antigens, which leads to damage to the cells expressing them. Purpose: To determine the diagnostic and practical value of quantitative indicators for the autoantibody complex to cardiomyocyte proteins to troponin I, to alpha-a ctin 1 and to the heavy chain of beta-myosin 7B in patients with cardiac pathology. Materials and Methods. The study of auto-antibodies to cTnI, ACTC1 and MUN7B in blood serum using laboratory enzyme immunoassay was carried out in patients with cardiac pathology undergoing inpatient treatment at the Regional Clinical Cardiology Dispensary in Stavropol. Additionally, an instrumental and laboratory examination was carried out in accordance with the clinical recommendations developed by the Association of Cardiovascular Surgeons, the Cardiological Society of Russia and approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation. The work was examined and approved by the Ethics Committee of the North Caucasus Federal University. Results and Discussion . Changes in the level of autoantibodies to cTnI, ACTC1 and MUN7B proteins in blood serum were statistically significant (p 0.01 v. s. p 0.01). A persistent increase in the level of auto-antibodies to cTnI by 2.36 ng/ml (694.11 %), to ACTC1 by 3.6 ng/ml (141.73 %) and to MUN7B by 1.74 ng/ml (119.17 %) was found in individuals with confirmed cardiac pathology, when other criteria for laboratory analysis were within acceptable values, which determine their diagnostic and evidentiary effectiveness. Conclusion . The results of the study showed the relationship of changes in the activity of cardiospecific auto-A T to cardiomyocyte proteins (Anti-cTnI, Anti ACTC1, Anti-M YH7B) in patients with cardiac pathologies, indicating not only systemic membrane disorders (membranopathies), but also serve as convincing evidence of direct chemical changes in cardiomyocytes. A correlation has also been established between cardiomarkers of necrosis and ischemia and autoimmune globulins Anti-cTnI, Anti ACTC1, Anti-MYH7B, that confirms diagnostic and practical value of this laboratory analysis.
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