文章摘要
帕金森病患者血清miR-34a、miR-129水平与认知障碍的相关性分析
Analysis of the correlation between serum miR-34a, miR-129 levels with cognitive impairment in Parkinson's disease patients
投稿时间：2025-01-20  修订日期：2025-01-20
DOI：
中文关键词: miR-34a  miR-129  帕金森病  诊断
英文关键词: miR-34a  miR-129  Parkinson's disease  diagnosis
基金项目:
作者单位邮编
任莎莎* 延安大学咸阳医院 712000
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中文摘要:
      目的：探讨miR-34a、miR-129在帕金森病患者血清中的表达水平变化及差异，分析其与患者认知障碍的相关性。方法：选取2020年5月至2023年5月在本院确诊的帕金森病患者186例，利用蒙特利尔认知评估量表（MoCA）评估帕金森病患者认知功能，以MoCA<26分为认知障碍组（n=97例），以MoCA≥26分为认知正常组（n=89例）。根据认知障碍程度分为轻度认知障碍35例、中度认知障碍44例与重度认知障碍18例。同时将180例健康志愿者纳为对照组。获得并整理比较一般临床资料。定量聚合酶链反应（qPCR）检测miR-34a和miR-129的水平，分析血清miR-34a和miR-129水平的差异和变化；帕金森病患者认知障碍发生因素以Logistic回归方式进行分析；血清miR-34a和miR-129水平对临床诊断帕金森病患者发生认知障碍效能以ROC曲线表示。结果：血清miR-34a、miR-129表达水平在帕金森患者中下调，差异显著（P<0.05）；不同认知功能帕金森病患者受教育年限比较有差异（P<0.05）；认知障碍组较认知正常组MoCA评分与血清miR-34a、miR-129表达水平均下调，比较有意义（P<0.05）；不同程度认知障碍帕金森病患者血清miR-34a、miR-129表达水平随严重程度均呈现下降趋势，即轻度认知障碍>中度认知障碍>重度认知障碍，差异显著且两两比较有意义（P<0.05）；受教育年限、miR-34a、miR-129表达水平均为该疾病发生认知障碍的保护因素（P<0.05）；两者联合诊断的AUC为0.901，敏感性、特异性分别为94.85%、66.29%，优于各自单独诊断（Z两者联合-miR-34a=2.084、Z两者联合-miR-129=2.340，P=0.037、P=0.019）。结论：帕金森病患者的血清中miR-34a和miR-129的含量明显低于正常人群，二者联合可以有效地辅助识别帕金森患者认知功能损害。
英文摘要:
      Objective: To investigate the changes and differences in the expression levels of miR-34a and miR-129 in the serum of Parkinson's disease patients, and to analyze their correlation with cognitive impairment in patients. Methods: From May 2020 to May 2023, 186 Parkinson's disease patients diagnosed in our hospital were collected, the Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of Parkinson's disease patients, and the patients with MoCA<26 points were classified as the cognitive impairment group (n=97), while those with MoCA ≥ 26 points were classified as the normal cognitive group (n=89). According to the degree of cognitive impairment, there were 35 cases of mild cognitive impairment, 44 cases of moderate cognitive impairment, and 18 cases of severe cognitive impairment. Meantime, 180 healthy volunteers were included as the control group. General clinical data were obtained and compared. Quantitative polymerase chain reaction (qPCR) was applied to detect the levels of miR-34a and miR-129, and the differences and changes in serum miR-34a and miR-129 levels was analyzed. The factors contributing to cognitive impairment in Parkinson's disease patients were analyzed using logistic regression. The efficacy of serum miR-34a and miR-129 levels in diagnosing cognitive impairment in Parkinson's disease patients was represented by ROC curves. Results: The expression levels of serum miR-34a and miR-129 were downregulated in Parkinson's patients (P<0.05). There was a obvious difference in the years of education of Parkinson's disease patients with different cognitive functions (P<0.05). The MoCA score and serum miR-34a and miR-129 expression levels were downregulated in the cognitive impairment group compared to the normal cognitive group (P<0.05). The expression levels of serum miR-34a and miR-129 in Parkinson's disease patients with different degrees of cognitive impairment showed a decreasing trend with severity, with mild cognitive impairment>moderate cognitive impairment>severe cognitive impairment, and the differences were obvious and pairwise comparisons were meaningful (P<0.05). The years of education, miR-34a, and miR-129 expression levels were all protective factors for cognitive impairment in this disease (P<0.05). The AUC of the combined diagnosis of the two was 0.901, with a sensitivity and specificity of 94.85% and 66.29%, respectively, the combined diagnosis were better than their individual diagnoses (Z combination - miR-34a=2.084, Z combination - miR-129=2.340, P=0.037, P=0.019). Conclusion: The levels of miR-34a and miR-129 in the serum of Parkinson's disease patients are obviously lower than those in the normal population. The combination of the two can effectively assist in identifying cognitive impairment in Parkinson's disease patients.
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