%0 Journal Article
%T miR-25、Aβ在认知功能障碍患者血清中表达的变化及临床意义
%A 范云　魏丽红　张三军　郑献召
%J -
%D 2020
%R 10.13362/j.jpmed.202002004
%X 摘要 目的　探讨血清微小核糖核酸25（miR-25）、β淀粉样蛋白（Aβ）在认知功能障碍（CI）患者血清中表达的变化及其临床意义。 方法　2017年5月－2019年3月在我院就诊的CI患者98例，包括阿尔茨海默病(AD)患者41例，轻度CI（MCI）患者57例，另外神经精神检查正常者50例作为对照组。记录所有受试者的简易智能精神状态检查量表（MMSE）评分。检测所有受试者血清中miR-25水平、Aβ40和Aβ42水平、Aβ42/Aβ40比值以及这些指标与MMSE评分的相关性。采用受试者工作特征（ROC）曲线确定miR-25、Aβ40、Aβ42、Aβ42/Aβ40对AD和MCI的诊断价值。 结果　与对照组比较，MCI组和AD组患者MMSE评分、血清中miR-25及Aβ42水平、Aβ42/Aβ40比值均降低，而且AD组患者MMSE评分、血清中miR-25水平和Aβ42/Aβ40比值低于MCI组患者，3组比较差异有显著性（F=11.172～212.874，P＜0.05）。Pearson相关性分析显示，血清中miR-25及Aβ42水平、Aβ42/Aβ40比值与MMSE评分呈正相关（r=0.165～0.691，P＜0.05），并且血清中miR-25水平与Aβ42水平、Aβ42/Aβ40比值也呈正相关（r=0.184、0.339，P＜0.05）。经ROC曲线分析，血清中miR-25联合Aβ42、Aβ42/Aβ40比值对CI患者（AUC为0.875，95%CI=0.770～0.956）及对AD患者（AUC为0.920，95%CI=0.879～0.995）诊断价值相对较高。 结论　血清中miR-25、Aβ42水平及Aβ42/Aβ40比值在CI患者中有所降低，联合检测对于CI和AD的诊断价值较高，为CI和AD患者分子生物学指标的研究提供了新的思路。<br>Abstract：Objective　To investigate the changes in the expression of microRNA-25 (miR-25) and amyloid β-protein (Aβ) and related clinical significance in patients with cognitive impairment (CI). Methods　A total of 98 patients with CI who attended our hospital from May 2017 to March 2019 were enrolled, among whom 41 had Alzheimer’s disease (AD) and 57 had mild CI (MCI), and 50 individuals with normal results of neuropsychiatric examination were enrolled as control group. Mini-Mental State Examination (MMSE) score was determined for all subjects. Serum levels of miR-25, Aβ40, and Aβ42 were measured for all subjects, Aβ42/Aβ40 ratio was calculated, and the correlation of these indices with MMSE score was also analyzed. The receiver operating characteristic (ROC) curve was used to investigate the value of miR-25, Aβ40, Aβ42, and Aβ42/Aβ40 ratio in the diagnosis of AD and MCI. Results　Compared with the control group, the MCI group and the AD group had significant reductions in MMSE score, serum levels of miR-25 and Aβ42, and Aβ42/Aβ40 ratio, and the AD group had significantly lower MMSE score, se- rum levels of miR-25 and Aβ42, and Aβ42/Aβ40 ratio than the MCI group (F=11.172-212.874,P<0.05). The Pearson analysis showed that the serum levels of miR-25 and Aβ42, and Aβ42/Aβ40 ratio were positively correlated with MMSE score (r=0.165-0.691,P<0.05), and the serum level of miR-25 was also positively correlated with Aβ42 level and Aβ42/Aβ40 ratio (r=0.184,0.339,P<0.05). The ROC curve analysis showed that serum level of miR-25 combined with serum Aβ42 level and Aβ42/Aβ40 ratio had a high value in the diagnosis of CI and AD, with an area under the ROC curve of 0.875 (95%CI=0.770-0.956) and 0.920 (95%CI=0.879-0.995), respectively. Conclusion　There are reductions in the serum levels of miR-25 and Aβ42,
%K 阿尔茨海默病
%K 认知功能障碍
%K 微RNAs
%K 淀粉样β肽类
%K 精神状态和痴呆测验
%K 诊断
%K ROC曲线<br>Alzheimer disease
%K Cognitive dysfunction
%K MicroRNAs
%K Amyloid beta-peptides
%K Mental status and dementia tests
%K Diagnosis
%K ROC curve
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202002004