MiR-137在缺血性卒中后抑郁患者外周血中的表达及其临床意义

Expression and its clinical significance of miR-137 in peripheral blood of patients with depression after ischemic stroke

目的探讨缺血性卒中后抑郁患者miR-137的变化及临床意义。方法采用中国急性缺血性脑卒中诊治指南2014急性脑梗死诊断标准、汉密尔顿抑郁量表(HAMD-24项)、精神障碍诊断及统计手册第五版(DSM-5)将研究对象分为正常对照组、抑郁症组各20例,并发抑郁组、未并发抑郁组各37例。运用实时荧光定量PCR方法(qRT-PCR)检测各组microRNA(miRNA)-137的表达水平,并对相关结果进行比较。结果四组样本的性别、年龄、合并高血压病、合并糖尿病、合并心脏病、NIHSS评分差异无统计学意义(均P>0.05)。与未并发抑郁组相比,并发抑郁组左侧脑梗死例数明显增高(P<0.05)。与正常对照组相比,未并发抑郁组、并发抑郁组miR-137水平明显降低(均P<0.05);与未并发抑郁组相比,并发抑郁组miR-137水平明显降低(P<0.05);并发抑郁组、抑郁症组miR-137水平差异无统计学意义(P>0.05)。结论缺血性脑卒中会引起miR-137表达水平的下降,并且miR-137表达水平的下降参与缺血性卒中后抑郁的形成。miR-137可以作为缺血性卒中后抑郁的预测、诊断及治疗指标。

Abstract： Objective To explore the changes of miR-137 of patients with depression after ischemic stroke and its clinical significance. Methods All the patients were separately divided into four groups according to the following rating scales： 2014 diagnostic criteria for acute cerebral infarction, Hamilton depression scale （HAMD-24）, Diagnostic and statistical manual of mental disorders, the fifth edition （ DSM-5 ） were applied to categorizing. According to the above grouping standards, all the patients were grouped as normal control group （ n = 20 ） , the depression group （ n = 20）, post-stroke depression group （ n = 37 ） , no depression after stroke group （ n = 37 ）. The expression level of mieroRNA （miR）-137 in each group was detected by quantitative real-time PCR （qRT-PCR）, and the results were compared. Results The difference of gender,age,chronic dieases,the site of infarction,NIHSS score had no statistical significance in the four group （ all P 〉 0. 05 ）, Compared with no depression after stroke group, the number of patients with left cerebral infarction was significantly increased in post-stroke depression group（ P 〈 0. 05 ）. Compared with the normal control group, miR-137 in no depression after stroke group and in post-stroke depression group significantly decreased（ all P 〈 0. 05 ） ; compared with no depression after stroke group, miR-137 in post-stroke depression group significantly decreased（P 〈 0. 05） ; the level of miR-137 between post-stroke depression group and depression group showed no statistical significance （ P 〉 0. 05 ）. Conclusions Isehemic stroke can induce the low expression of miR-137 which participates in the formation of post-stroke depression, miR-137 may act as a predictive, diagnostic,therapeutic index of poststroke depression.