摘要
目的 探究血管性认知功能障碍(VCI)病人血清微RNA(miR)-335-5p、血清应答因子(SRF)水平及临床意义。方法以石家庄市人民医院2019年1月至2020年12月因脑卒中治疗后6个月出现VCI的110例病人为研究对象(VCI组),其中非痴呆型血管性认知功能障碍(VCIND)者48例(VCIND组)、血管性痴呆(VD)者62例(VD组)。同时间段该院脑卒中未合并认知障碍者110例为对照组。分析各组病人发病时(入院次日)、发病后6个月、发病后1年血清miR-335-5p、SRF水平。logistic回归模型分析脑卒中病人发生VCI的影响因素。Pearson法分析血清miR-335-5p与SRF水平的相关性。受试者操作特征曲线(ROC曲线)分析血清miR-335-5p、SRF水平对VCI的预测价值。结果 VCI组发病时miR-335-5p水平0.76±0.15低于对照组1.06±0.07,而SRF水平1.52±0.24高于对照组1.01±0.09,差异有统计学意义(P<0.05)。发病时,对照组、VCIND组、VD组的miR-335-5p水平逐次降低(1.06±0.07比0.86±0.17比0.68±0.14),SRF水平依次增加(1.01±0.09比1.32±0.25比1.67±0.24),差异有统计学意义(P<0.05)。VD组、VCIND组受试者在发病后6个月及1年时SRF水平低于发病时,而miR-335-5p水平高于发病时(P<0.05)。三组蒙特利尔认知评估量表(MoCA)评分、miR-335-5p、SRF组间、时间、交互作用差异有统计学意义(P<0.05)。发病时,VCI组血清miR-335-5p与SRF水平存在负相关性(r=-0.64,P<0.001)。年龄、美国国立卫生研究院卒中量表(NIHSS)评分、miR-335-5p、SRF是影响脑卒中病人VCI的危险因素(P<0.05)。ROC分析显示,血清miR-335-5p、SRF、miR-335-5p联合SRF预测脑卒中后VCI的曲线下面积为0.88[95%CI:(0.84,0.93)]、0.90[95%CI:(0.86,0.95)]、0.93[95%CI:(0.89,0.97)]。结论VCI病人血清miR-335-5p水平明显降低,而SRF水平升高,二者水平变化与VCI严重程度有关,是导致脑卒中后VCI的影响因素,且二者联合对脑卒中后VCI有较高预测效能。
Objective To investigate the levels and clinical significance of serum microRNA(miR)-335-5p and serum response factor(SRF) in patients with vascular cognitive impairment(VCI).Methods A total of 110 patients with VCI at 6 months after stroke treatment in Shijiazhuang People's Hospital from January 2019 to December 2020 were selected as the study subjects(VCI group),including 48 cases with vascular cognitive impairment with no dementia(VCIND group) and 62 cases with vascular dementia(VD group).In the same period,110 patients with cerebral apoplexy without cognitive impairment were selected as the control group.The serum levels of miR-335-5p and SRF in each group were analyzed at the time of onset(the next day after admission),6 months after onset,and 1year after onset.Logistic regression model was used to analyze the influencing factors of VCI in stroke patients.The correlation between serum miR-335-5p and SRF levels was analyzed by Pearson method.Receiver operating characteristic curve(ROC) was used to analyze the predictive value of serum miR-335-5p and SRF levels for VCI.Results The level of miR-335-5p(0.76±0.15) in the VCI group was lower than that in the control group(1.06±0.07),while the level of SRF(1.52±0.24) was higher than that in the control group(1.01±0.09),and the difference was statistically significant(P<0.05).At the time of onset,the levels of miR-335-5p in the control group,VCIND group and VD group decreased successively(1.06±0.07 vs.0.86±0.17 vs.0.68±0.14),and the levels of SRF increased successively(1.01±0.09 vs.1.32±0.25 vs.1.67±0.24),and the difference was statistically significant(P<0.05).The level of SRF in VD group and VCIND group at 6 months and 1 year after onset was lower than that at onset,while the level of miR-335-5p was higher than that at onset(P<0.05).There were significant differences in MoCA score,miR-335-5p,SRF,time and interaction among the three groups(P<0.05).At the time of onset,there was a negative correlation between the levels of serum miR-335-5p and SRF in VCI group(r=-0.64,P<0.001).Age,NIHSS score,miR-335-5p and SRF were risk factors for VCI in stroke patients(P<0.05).ROC analysis showed that the area under the curve of serum miR-335-5p,SRF,miR-335-5p combined with SRF in predicting VCI after stroke were 0.88 [95%CI:(0.84,0.93)],0.90 [95%CI:(0.86,0.95)] and 0.93 [95%CI:(0.89,0.97)],respectively.Conclusions The level of serum miR-335-5p in patients with VCI is significantly decreased,while the level of SRF is increased.The changes of the two levels are related to the severity of VCI,which is the influencing factor of VCI after stroke.The combination of miR-335-5p and SRF has high predictive efficiency for VCI after stroke.
作者
姚洁
王尚臣
褚丽芳
朱倩
YAO Jie;WANG Shangchen;CHU Lifang;ZHU Qian(Department of Neurology,Shijiazhuang People's Hospital,Shijiazhuang,Hebei 050000,China)
出处
《安徽医药》
CAS
2024年第3期597-602,共6页
Anhui Medical and Pharmaceutical Journal
基金
石家庄市科学技术研究与发展计划项目(211201313)。
