miR-93-5p联合BDNF蛋白检测卒中后认知功能障碍的诊断价值
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摘要
目的:探讨miR-93-5p联合BDNF蛋白检测对PSCI的诊断价值。方法:选取2018年1～9月就诊于福建中医药大学附属康复医院住院部及门诊的脑卒中患者50例,MoCA评分小于22分作为卒中后认知障碍组26例,MoCA评分大于26分作为卒中后认知正常组24例,健康体检者25例作为对照组,采用Real-time PCR检测并比较三组受试者血清miR-93-5p表达水平,采用ELISA测定并比较三组患者血清BDNF水平,同时采用ROC曲线分析联合检测miR-93-5p和BDNF对PSCI的诊断价值。结果:PSCI组患者血清miR-93-5p表达水平明显高于PSCN组和对照组,血清BDNF表达水平明显低于PSCN组和对照组,且差异具有统计学意义(P<0. 05)。ROC曲线结果显示,miR-93-5p和BDNF水平联合诊断PSCI的曲线下面积、灵敏度、特异度均较miR-93-5p、BDNF水平单独预测高,差异具有统计学意义(P<0. 05)。结论:miR-93-5p联合BDNF检测诊断PSCI的灵敏度和特异度均较高,诊断价值良好,可以作为诊断PSCI的参考指标。
Objective: To study the value of miR-93-5 p combined with BDNF protein in the diagnosis of post-cognitive impairment. Methods: From January to September 2018, 50 case of patients with diagnosed stroke, after the evaluation of the MoCA scale, 26 cases of stroke patients which MoCA<22 were selected as the PSCI group, 24 cases of stroke patients which MoCA>26 were selected as the PSCN group, 25 cases of healthy examinees were selected as the control group, the serum miR-93-5 p levels of the 3 groups were detected and measured by Real-time PCR assay. Serum BNDF protein of the 3 groups were detected and measured by ELISA. At the time, ROC curve analysis were used to detect the diagnostic value of miR-93-5 p combined BDNF for post-cognitive impairment. Results: The miR-93-5 p and BDNF levels of the PSCI group were significantly higher than that of PSCN and control group, however the BDNF levels were significantly lower than that of the PSCN and control group, the difference were statistically significant(P<0.05). The results of ROC curve showed that the area, sensitivity and specificity of PSCI diagnosed by miR-93-5 p and BDNF were significantly higher than that of miR-93-5 p, BDNF alone(P<0.05).Conclusion: miR-93-5 p combined with BDNF in the diagnosis of post-cognitive impairment have higher sensitivity and specificity,miR-93-5 p combined with BDNF may become reference index for post-cognitive impairment diagnosis.
Objective: To study the value of miR-93-5 p combined with BDNF protein in the diagnosis of post-cognitive impairment. Methods: From January to September 2018, 50 case of patients with diagnosed stroke, after the evaluation of the MoCA scale, 26 cases of stroke patients which MoCA<22 were selected as the PSCI group, 24 cases of stroke patients which MoCA>26 were selected as the PSCN group, 25 cases of healthy examinees were selected as the control group, the serum miR-93-5 p levels of the 3 groups were detected and measured by Real-time PCR assay. Serum BNDF protein of the 3 groups were detected and measured by ELISA. At the time, ROC curve analysis were used to detect the diagnostic value of miR-93-5 p combined BDNF for post-cognitive impairment. Results: The miR-93-5 p and BDNF levels of the PSCI group were significantly higher than that of PSCN and control group, however the BDNF levels were significantly lower than that of the PSCN and control group, the difference were statistically significant(P<0.05). The results of ROC curve showed that the area, sensitivity and specificity of PSCI diagnosed by miR-93-5 p and BDNF were significantly higher than that of miR-93-5 p, BDNF alone(P<0.05).Conclusion: miR-93-5 p combined with BDNF in the diagnosis of post-cognitive impairment have higher sensitivity and specificity,miR-93-5 p combined with BDNF may become reference index for post-cognitive impairment diagnosis.
引文
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[12]刘宇明,邓燕华,许治强,等.脑出血患者血清NSE、GFAP、BDNF水平变化与认知障碍相关性研究[J].脑与神经疾病杂志,2016,24(10):623-626.
[13]王鑫,孙彩花,施伟,等.音乐疗法对卒中后认知障碍的临床疗效[J].实用临床医学杂志,2014,16(19):10-13.
[14] Wayman GA, Davare M,Ando H,et al.An activity-regulated microRNA controls dendritic plasticity by down-regulating p250GAP[J]. Proc Natl Acad Sci U S A,2008,105(26):9093-9098.
[15] Bjorn Tews,Kai Schonig,Michael E,et al.Synthetic microRNA-mediated downregulation of Nogo-A in transgenic rats reveals its role as regulator of synaptic plasticity and cognitive function[J].Proc Natl Acad Sci U S A,2013,110(16):6583-6588.
[16] Wang P,Liang X,Lu Y,et al.MicroRNA-93 downregulation ameliorates cerebral ischemic injury through the Nrf2/HO-1 defense pathway[J].Neurochem Res,2016,41(10):2627-2635.
[17] Tian F,Yuan C,Hu L,et al.MicroRNA-93 inhibits inflammatory responses and cell apoptosis after cerebral ischemia reperfusion by targeting interleukin-1 receptor-associated kinase 4[J]. Exp Ther Med,2017,14(4):2903-2910.
[2] Takahashi N, Kawamura M. Cognitive impairment after stroke[J].Cureus, 2015, 7(9):345.
[3] Jin YP,Di Legge S,Ostbye T,et al.The reciprocal risks of stroke and cognitive impairment in an elderly population[J]. Alzheimers Dement,2006,2(3):171-178.
[4]解恒革.认知损害应成为卒中后综合管理的重点[J].中华内科杂志,2017,56(2):89.
[5] Ebert, Margaret S, Sharp, Phillip A. Roles for MicroRNAs in Conferring Robustness to Biological Processes[J]. Cell, 2012, 149(3):515-524.
[6] Kim J M,Stewart R,Park MS,et al.Associations of BDNF genotype and promoter methylation with acute and long-term stroke out-comes in an East Asian cohort[J].Plos One,2012,7(12):e51280.
[7]中华神经科学会.全国第四届脑血管病学术会议脑卒中患者临床功能缺损程度评分标准(1995)[J].华西医学,1996,29(2):381.
[8]刘忠玲,李华.事件相关电位P300和蒙特利尔认知评估量表对不同部位脑卒中患者早期认知功能的评估价值研究[J].中国全科医学,2013,16(7):2338-2348.
[9]国家卫生计生委脑卒中防治工程委员会.中国脑卒中护理指导规范[C].北京:2016年中国脑卒中大会,2016.
[10] Petersen R C. Clinical practice. Mild cognitive impairment[J]. N Engl J Med, 2011, 364(23):2227-2234.
[11]李金路,谭莹,衡新华.丙泊酚对脑损伤大鼠认知功能及BDNF表达的影响[J].昆明医科大学学报,2016,37(8):30-34.
[12]刘宇明,邓燕华,许治强,等.脑出血患者血清NSE、GFAP、BDNF水平变化与认知障碍相关性研究[J].脑与神经疾病杂志,2016,24(10):623-626.
[13]王鑫,孙彩花,施伟,等.音乐疗法对卒中后认知障碍的临床疗效[J].实用临床医学杂志,2014,16(19):10-13.
[14] Wayman GA, Davare M,Ando H,et al.An activity-regulated microRNA controls dendritic plasticity by down-regulating p250GAP[J]. Proc Natl Acad Sci U S A,2008,105(26):9093-9098.
[15] Bjorn Tews,Kai Schonig,Michael E,et al.Synthetic microRNA-mediated downregulation of Nogo-A in transgenic rats reveals its role as regulator of synaptic plasticity and cognitive function[J].Proc Natl Acad Sci U S A,2013,110(16):6583-6588.
[16] Wang P,Liang X,Lu Y,et al.MicroRNA-93 downregulation ameliorates cerebral ischemic injury through the Nrf2/HO-1 defense pathway[J].Neurochem Res,2016,41(10):2627-2635.
[17] Tian F,Yuan C,Hu L,et al.MicroRNA-93 inhibits inflammatory responses and cell apoptosis after cerebral ischemia reperfusion by targeting interleukin-1 receptor-associated kinase 4[J]. Exp Ther Med,2017,14(4):2903-2910.