miR-134在脑卒中后认知障碍患者血清中表达及意义

Expression and Significance of miR-134 in Serum of Patients with Cognitive Impairment after Stroke

目的:探讨miR-134作为血清学标记物在脑卒中后认知障碍(PSCI)的临床意义。方法:采用蒙特利尔认知评估量表(MoCA)、贝克抑郁量表(BDI)进行评定并招募27名PSCI患者、29名脑卒中后认知功能正常(PSCN)患者以及28名对照组(AMC)。采用RT-qPCR检测并比较三组血清miR-134表达水平,用ROC曲线评价血清miR-134表达水平对PSCI诊断的敏感度和特异度;采用ELISA测定并比较三组患者血清BDNF水平,分析血清miR-134表达水平与MoCA评分及BDNF水平的相关性。结果:与PSCN、AMC患者相比,miR-134及BDNF水平在PSCI患者血清中呈显著下调状态(P<0.01);血清miR-134相对表达水平与MoCA得分之间存在中度正相关(r=0.613,P<0.01);miR-134曲线下面积(95%CI)为0.849(0.749-0.948,P<0.01),灵敏度为88.89%,特异度为62.07%。血清miR-134相对表达量与BDNF水平呈现中度正相关(r=0.734,P<0.01)。结论:miR-134作为血清学标记物,可以较好地应用于PSCI的临床诊断,在PSCI早期发病中起着重要预警作用。

Objective:To investigate the clinical significance of Mir-134 as a serological marker in patients with stroke before and after cognitive dysfunction(PSCI),the changes of serum marker Mir-134 were detected.Methods:Twenty-seven patients with PSCI,29 patients with normal cognitive function after stroke(PSCN)and 28 controls(AMC)were recruited using the Montreal Cognitive Assessment(MoCA)and Beck Depression Inventory(BDI).There were no significant differences in age,sex and education among the three groups.The serum Mir-134 expression levels of the three groups were detected and compared by RT-QPCR,and the sensitivity and specificity of serum Mir-134 expression levels to PSCI diagnosis were evaluated by ROC curve.The serum BDNF levels of patients in the three groups were determined and compared by ELISA,and the correlation between serum Mir-134 expression level and MoCA score and BDNF level was analyzed.Results:Compared with PSCN and AMC patients,mir-134 and BDNF levels were significantly down-regulated in the serum of PSCI patients(P<0.01).There was a moderate positive correlation between serum Mir-134 relative expression level and MoCA score(r=0.613,P<0.01).The area under the curve(95%CI)of Mir-134 was 0.849(0.749-0.948,P<0.01),the sensitivity was 88.89%,and the specificity was 62.07%.The relative expression level of serum Mir-134 was moderately positively correlated with the level of BDNF(r=0.734,P<0.01).Conclusion:As a serological marker,Mir-134 can be well applied in the clinical diagnosis of PSCI,and plays an important role in the early warning of PSCI.