老年帕金森病患者血清miR-124、miR-494表达及其临床意义

Expressions and clinical significance of miR-124 and miR-494 in elderly patients with Parkinson disease

目的探讨老年帕金森病(Parkinson disease,PD)患者血清微小RNA-124(miR-124)、微小RNA-494(miR-494)表达水平及其临床意义。方法选取2018年3月~2020年4月在郑州大学附属郑州中心医院住院治疗的90例PD患者(PD组);同期选择在医院体检中心检查且与PD患者年龄、性别相匹配的100名非PD老年人作对照组。所有研究对象空腹12 h后取清晨静脉血4 ml,采用帕金森等级量表(unified Parkinson disease rating scale,UPDRS)对所有PD组患者从精神状态、行为和情感、生活质量、运动检查进行评分,利用帕金森病Hoehn-Yahr分级量表对PD患者进行分级;利用实时荧光定量PCR(qRT-PCR)技术检测血清miR-124和miR-494表达水平;作ROC曲线判断miR-124、miR-494对PD患者的诊断价值。结果UPDRS评分≤60分的PD患者Hoehn-Yahr分级明显低于UPDRS>60分的患者[(2.47±0.43)分,(3.42±0.47)分],差异有统计学意义(t=9.055,P<0.001),但血清miR-124、miR-494表达水平差异无统计学意义[miR-124:(0.72±0.14),(0.70±0.12);miR-494:(1.17±0.19),(1.18±0.22)](t=0.633,0.230,P=0.529,0.819);与对照组相比,PD组血清miR-124表达下调[(0.71±0.20),(1.05±0.24)],miR-494表达上调[(1.18±0.26),(0.96±0.22)](t=10.542,6.315,均P<0.001);ROC曲线结果显示,血清miR-124、miR-494诊断PD的曲线下面积(AUC)分别为0.847,0.760,截断值分别为0.901,1.126,灵敏度分别为86.67%、61.11%,特异度分别为75.03%、79.00%;二者联合诊断PD的AUC为0.898,灵敏度和特异度分别为85.56%、85.00%。结论PD患者血清miR-124呈低表达,miR-494呈高表达,提示二者的水平变化可能与PD的发生、发展有关。二者均对PD有一定的诊断价值,且联合诊断价值更高。

Objective To investigate the expression levels of microRNA-124(miR-124)and microRNA-494(miR-494)in the serum of elderly patients with Parkinson disease(PD)and its clinical significance.Methods Ninety PD patients(PD group)who were hospitalized in Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2018 to April 2020 were selected.At the same time,100 non-PD elderly people examined in the physical examination center of the same hospital who matched with age and gender of PD patients were selected as the control group.After 12 hours of fasting,4 ml of venous blood was taken from all subjects.All PD patients were graded by unified Parkinson disease rating scale(UPDRS)from the aspects of mental state,behavior and emotion,quality of life and motor examination,and graded by the Hoehn-Yahr rating scale for Parkinson disease.The expression levels of miR-124 and miR-494 in serum were detected by real-time fluorescent quantitative PCR(qRT-PCR),and the diagnostic values of miR-124 and miR-494 in PD patients were evaluated by ROC curve.Results Hoehn-Yahr grade of PD patients with UPDRS≤60 points was significantly lower than that of patients with UPDRS>60 points((2.47±0.43)vs(3.42±0.47))(t=9.055,P<0.001),and there was no significant difference in serum miR-124 and miR-494 expression levels((0.72±0.14)vs(0.70±0.12),(1.17±0.19)vs(1.18±0.22))(t=0.633,0.230,P=0.529,0.819).Compared with that in control group,the expression of miR-124 in PD group was down-regulated((0.71±0.20)vs(1.05±0.24)),and the expression of miR-494 was up-regulated((1.18±0.26)vs(0.96±0.22))(t=10.542,6.315,P<0.001).The results of ROC showed that the area under curve(AUC)of serum miR-124 and miR-494 in the diagnosis of PD were 0.847 and 0.760 respectively,the cutoff values were 0.901 and 1.126,respectively,the sensitivities were 86.67%and 61.11%respectively,and the specificities were 75.03%and 79.00%respectively.The AUC of the combined diagnosis of PD was 0.898,and the sensitivity and specificity were 85.56%and 85.00%respectively.Conclusions The expression of miR-124 is low in PD patients,while the expression of miR-494 is high,which suggests that the changes of the two miRNA levels may be related with the occurrence and development of PD.Both of them have a certain diagnostic value for PD,and the value of combined diagnosis is higher.