血清miR-124、miR-132、miR-134对卒中后认知障碍的预测作用

Prediction of Post-Stroke Cognitive Impairment by Serum miR-124, miR-132, miR-134

摘要: 背景：卒中后痴呆是脑卒中后最常见的心理行为障碍并发症，其增加了死亡率，极大降低了卒中患者的生活质量。目前的研究认为，血清微小RNA、氧化应激因子、血清代谢物等生物学标志物等危险因素均可作为PSCI的预警因子，但尚无统一定论。因此亟须寻找新的诊断标志物和诊断方法以提升PSCI患者等的早期检出率。目的：探讨miR-124、miR-132、miR-134对卒中后认知障碍(post-stroke cognitive impairment, PSCI)的预测效能。方法：选取2021年5月至2022年10月本院收治的67例脑梗死患者，根据6个月内是否发生卒中后认知障碍分为PSCI组(n = 33)、卒中后认知正常(post-stroke cognitive normality, PSCN)组(n = 34)，同时收集36例健康对照组的样本。采用实时定量聚合酶链式反应(qRT-PCR)方法检测miR-124、miR-132与miR-134的表达。ANOVA检验比较三组基线资料和miR-124、miR-132、miR-134与简易智力状态检查量表(MMSE)评分，采用Pearson及偏相关性分析miR-124、miR-132、miR-134与MMSE评分相关性，受试者工作特征曲线(ROC)分析miR-124、miR-132、miR-134预测PSCN的价值。结果：miR-124、miR-132、miR-134均在PSCI组的表达最高，其次是PSCN组和健康对照组；PSCI组的MMSE评分最低，其次是PSCN组和AMC组，差异有统计学意义(P < 0.05)；miR-124、miR-132、miR-134与MMSE评分呈负相关(P < 0.05)；miR-124、miR-132、miR-134预测PSCI的AUC为0.902，大于单一指标预测(P < 0.05)。结论：miR-124、miR-132、miR-134可作为临床评估脑梗死后PSCI发生风险的非侵入性指标，有助于临床早期识别、干预，以改善患者预后。

Abstract: Background: Post-stroke dementia is the most common complication of psychological and behav-ioral disorders after stroke, which increases mortality and greatly reduces the quality of life of stroke patients. According to the current research, serum micro-RNA, oxidative stress factors, se-rum metabolites and other risk factors can be used as early warning factors of PSCI, but there is no unified conclusion. Therefore, there is an urgent need to find new diagnostic markers and diagnos-tic methods to improve the early detection rate of PSCI patients. Objective: To explore the predic-tive efficacy of miR-124, miR-132 and miR-134 in post-stroke cognitive impairment (PSCI). Methods: Sixty-seven patients with cerebral infarction treated in our hospital from May 2021 to October 2022 were divided into PSCI group (n = 33) and post-stroke cognitive normality group (n = 34) according to the occurrence of post-stroke cognitive impairment within 6 months. At the same time, 36 healthy controls were collected. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-124, miR-132 and miR-134. The baseline data of the three groups and the scores of miR-124, miR-132, miR-134 and mini-mental state examination (MMSE) were compared by ANOVA test. Pearson and partial correlation were used to analyze the correlation between miR-124, miR-132, miR-134 and MMSE scores. The value of miR-124, miR-132 and miR-134 in predicting PSCN was analyzed by receiver working characteristic curve (ROC). Results: The scores of miR-124, miR-132 and miR-134 were the highest in PSCI group, followed by PSCN group and healthy control group, the MMSE score of PSCI group was the lowest, followed by PSCN group and AMC group, the difference was statistically significant (P < 0.05), miR-124, miR-132, miR-134 were negatively correlated with MMSE score (P < 0.05), and the AUC of PSCI predicted by miR-124, miR-132 and miR-134 was 0.902, which was higher than that predicted by single index (P < 0.05). Conclusion: miR-124, miR-132 and miR-134 can be used as non-invasive indexes to evalu-ate the risk of PSCI after cerebral infarction, which is helpful for early clinical identification and in-tervention to improve the prognosis of patients.