血清与脑脊液miR-132、NSE、α_(2)M水平在老年急性脑梗死后血管性痴呆中的变化及临床意义  

Changes in Serum and Cerebrospinal Fluid miR-132, NSE, and α_(2)M Levels in Vascular Dementia after Acute Cerebral Infarction in the Elderly and Their Clinical Significances

作　　者：闫秀娟 李博[1] 李宝柱[1] 刘京锋[1] 张烜[1] YAN Xiu-juan;LI Bo;LI Bao-zhu;LIU Jing-feng;ZHANG Xuan(Department of Neurology,Beijing Hepingli Hospital,Beijing 100013,China)

机构地区：[1]北京市和平里医院神经内科,北京100013

出　　处：《临床误诊误治》2022年第5期108-112,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2019年东城区科技计划项目(S20190701001)。

摘　　要：目的探讨血清与脑脊液微小RNA-132(miR-132)、神经元特异性烯醇化酶(NSE)、α_(2)巨球蛋白(α_(2)M)水平在老年急性脑梗死后血管性痴呆(VD)中的变化及临床意义。方法选取2019年4月—2021年6月收治的老年急性脑梗死后VD 78例作为VD组,无VD 78例作为无VD组。比较两组血清、脑脊液miR-132、NSE、α_(2)M水平,分析血清、脑脊液miR-132、NSE、α_(2)M水平相关性,评价各指标对VD发生的相对危险度的预测价值,并比较VD组不同病情程度患者血清与脑脊液miR-132、NSE、α_(2)M水平,分析各指标与VD病情程度的关系及鉴别诊断价值。结果VD组血清、脑脊液miR-132、NSE、α_(2)M水平高于无VD组(P<0.05)。血清、脑脊液miR-132、α_(2)M与NSE呈正相关,miR-132与α_(2)M呈正相关(P<0.01)。高水平血清、脑脊液miR-132、α_(2)M与NSE患者发生VD的相对危险度高于低水平患者(P<0.05,P<0.01)。VD组重度患者血清、脑脊液miR-132、NSE、α_(2)M水平高于中度和轻度患者,且中度患者高于轻度患者(P<0.05)。血清、脑脊液miR-132、NSE、α_(2)M水平与VD病情程度呈正相关(P<0.05)。血清、脑脊液miR-132、NSE、α_(2)M水平鉴别VD病情程度的曲线下面积均>0.7。结论血清与脑脊液miR-132、NSE、α_(2)M在老年急性脑梗死后VD中呈异常高表达,增加VD发生危险度,且与病情程度密切相关。Objective To investigate the changes of serum and cerebrospinal fluid microRNA-132(miR-132),neuron-specific enolase(NSE)andα_(2) macroglobulin(α_(2)M)levels in vascular dementia(VD)after acute cerebral infarction(ACI)in the elderly and their clinical significances.Methods Seventy-eight elderly patients with VD after ACI admitted from April 2019 to June 2021 were selected as the VD group,and 78 patients without VD were selected as the non-VD group.The levels of miR-132,NSE andα_(2)M in serum and cerebrospinal fluid of the two groups were compared,and the correlation between the levels of miR-132,NSE andα_(2)M in serum and cerebrospinal fluid was analyzed.The predictive value of each index in the risk factors of the occurrence of VD was evaluated,and the levels of miR-132,NSE andα_(2)M in serum and cerebrospinal fluid Were compared in patients with different severity in VD group.The relationship between each index and the severity of VD and differential diagnosis value were analyzed.Results The levels of miR-132,NSE andα_(2)M in serum and cerebrospinal fluid in the VD group were higher than those in the non-VD group(P<0.05).The miR-132 andα_(2)M in serum and cerebrospinal fluid were positively correlated with NSE,and miR-132 was positively correlated withα_(2)M(P<0.01).The relative risk of VD in patients with high levels of miR-132,α_(2)M and NSE in serum and cerebrospinal fluid was higher than that in patients with low levels(P<0.05,P<0.01).The miR-132,NSE andα_(2)M levels of serum and cerebrospinal fluid in severe patients in VD group were higher than those of moderate and mild patients,and higher in moderate VD patients than in mild VD patients(P<0.05).The miR-132,NSE,andα_(2)M levels of serum and cerebrospinal fluid were positively correlated with the severity of VD(P<0.05).The areas under the ROC curve of serum and cerebrospinal fluid miR-132,NSE andα_(2)M levels in differentiating the severity of VD were all>0.7.Conclusion Serum and cerebrospinal fluid miR-132,NSE andα_(2)M are abnormally highly

关 键 词：痴呆 血管性 脑梗死 微小RNA-132 神经元特异性烯醇化酶 α_(2)巨球蛋白 

分 类 号：R749.16[医药卫生—神经病学与精神病学]