Eur Heart J:用于心脏病筛查的“临床风险”和生物标记物

2019-01-12 佚名 中国生物技术网

近日,英国伯明翰大学的研究人员发现了两种生物标志物,可以用来识别有三种“临床风险”患者的房颤,房颤是一种心脏疾病。

近日,英国伯明翰大学的研究人员发现了两种生物标志物,可以用来识别有三种“临床风险”患者的房颤房颤是一种心脏疾病。

房颤是最常见的心律失常,患者能够明显地感觉到心脏仿佛猛烈地撞击、颤抖,或者不规律地跳动。有时房颤不会引起任何症状,患者完全不知道自己的心率是紊乱的。

现在,研究人员已经确定,如果患者有三种“临床风险”,那么他们就更容易患有房颤。这些风险因素包括年龄大、男性且身体质量指数(BMI)高。研究人员说,这些患者可以通过血液测试来检测是否有两种生物标志物水平升高,从而对房颤进行筛查。一种是由心脏分泌的叫做脑利钠肽(BNP)的激素,另一种是负责磷酸盐调节的成纤维细胞生长因子-23(FGF-23)。

伯明翰大学医学和牙科科学学院癌症和基因组科学研究所以及血管科学研究所的科学家们完成了这项研究。该研究1月7日已发表在《European Heart Journal》上。



研究第一作者Winnie Chua博士说:“房颤患者更容易发生血栓和中风。为了避免中风,他们服用抗凝药物来防止血液凝结是很重要的。然而,房颤通常只有在患者中风后才会被诊断出来。因此,重要的是,我们应该对面临风险的患者进行筛查,以便让他们及时服用抗凝剂,以预防潜在危及生命的并发症。”

共同第一作者Yanish Purmah补充说:“心电图(ECG)是一种测量心脏电活动以显示其是否正常工作的测试,通常用于筛查患者的房颤。但ECG筛查非常耗资源,对于患者来说负担很重,因此选择合适的患者进行此类筛查非常重要。我们已经确定的这两种生物标志物具备在社区环境中使用的潜力,比如在全科医生的诊所就可以通过血液测试来评估,从而简化选择ECG筛查患者的过程。”

到目前为止,大多数房颤患者中识别生物标志物的研究都是基于假设的,涉及对单个或者少量血液生物标志物的分析。在这项研究中,研究人员分析了2014年9月至2016年8月期间招募的638名医院患者的40种常见血管生物标志物。为了获得这个结果,他们将传统的统计分析方法与全新的机器学习技术相结合。

通讯作者Larissa Fabritz博士说:“研究结果非常令人惊讶。虽然BNP是一种已知且被广泛应用于临床的生物标志物,但是围绕FGF-23生物标志物有效性的研究结果却是个令人意外的新发现。FGF-23目前只在基于研究的环境中使用,但我们已经展示了它在临床环境中的价值。”

研究负责人、伯明翰大学心血管科学研究所主任Paulus Kirchhof教授说:“我们希望,更多患有这种不易察觉疾病的人可以被及早诊断,从而防止并发症的发生。”

英国心脏基金会(BHF)助理医学主任Metin Avkiran教授补充说:“房颤增加了中风的风险,中风是一种严重的疾病,只英国每年就有超过36000人死于中风,但中风往往发现得太晚。我们使用复杂的统计学和机器学习方法来分析患者数据,并提供令人鼓舞的证据,即可以使用易于测量的指标组合来预测房颤。这项研究为更好地检测房颤患者铺平了道路,并有助于利用血液稀释药物进行针对性治疗以预防中风及其严重的后果。”

原始出处:
Winnie Chua  Yanish Purmah  Victor R Cardoso, et al. Data-driven discovery and validation of circulating blood-based biomarkers associated with prevalent atrial fibrillation. European Heart Journal. Jan 7, 2019.

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    2019-08-25 wjywjy
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    2019-01-14 zhaojie88
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    2019-01-14 slcumt

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