【摘要】 目的探讨颈动脉狭窄患者支架植入术后认知功能变化与微RNA-24(miR-24)的关系。方法前瞻性选取2017年2月至2019年2月在湖北民大医院接受支架植入术治疗的135例颈动脉狭窄患者作为研究对象。采用实时定量聚合酶链反应(RT-qPCR)检测血清miR-24相对表达量,分析支架植入术前后miR-24变化值(△miR-24)与蒙特利尔认知评估量表(MoCA)变化值(△MoCA)、画钟测试(CDT)变化值(△CDT)、额叶功能评定量表(FAB)变化值(△FAB)、听觉词语学习测试(AVLT)变化值(△AVLT)、符号-数字模式测试(SDMT)变化值(△SDMT)、Rey-Osterriech复杂图形测试(CFT)变化值(△CFT)的关系。多元线性回归法分析miR-24变化值与认知功能变化的相关性。结果轻度狭窄(n=31)、中度狭窄(n=48)、重度狭窄(n=53)、闭塞(n=3)患者miR-24相对表达分别为(0.99±0.23)%、(0.76±0.20)%、(0.61±0.17)%、(0.29±0.14)%,轻度狭窄、中度狭窄、重度狭窄患者均高于闭塞患者(P<0.001)。支架植入术后患者MoCA、CDT、FAB、AVLT、SDMT评分均较术前显著升高(P<0.001), miR-24相对表达显著高于术前[(1.15±0.36)%对(0.74±0.18)%,P<0.001]。多元线性回归分析显示△miR-24与△CDT、△SDMT、△CFT呈正相关(P<0.05),与△FAB呈负相关(P>0.05)。结论颈动脉狭窄患者支架植入术后患者认知功能明显改善,主要体现在时间、空间定向力、注意力及视觉空间感知能力等方面,其机制可能与促进miR-24表达有关。更多还原

【Abstract】 Objective To investigate the relationship between cognitive function changes and serum microRNA-24(miR-24) expression in patients with carotid stenosis after stent implantation. Methods In this prospective study a total of 135 patients with carotid stenosis, who underwent carotid stent implantation at the Affiliated Minda Hospital of Hubei University for Nationalities of China between February 2017 and February2019, were enrolled as the study subjects. Real-time fluorescence quantitative PCR(RT-qPCR) was used to detect the relative expression of serum miR-24. The relationship between the changes of miR-24 value(△miR-24) and the changes in Montreal cognitive assessment value(△MoCA), clock drawing test(△CDT), frontal assessment battery(△FAB), auditory verb learning test(△AVLT), symbol-digit modality test(△SDMT) and Rey-Osterriech complex graphics test(CFT) value(△CFT) were analyzed before and after stent implantation.Multivariate linear regression method was adopted to analyze the correlation between △miR-24 and △MoCA.Results The relative expression of miR-24 in mild stenosis group(n=31), moderate stenosis group(n=48) and severe stenosis group(n=3) was(0.99±0.23)%,(0.76±0.20)% and(0.61±0.17)% respectively, which was remarkably higher than(0.29±0.14)% in occlusion group(n=3)(P<0.001). After stent implantation, the scores of MoCA,CDT, FAB, AVLT and SDMT were strikingly increased when compared with preoperative ones(P<0.001), the postoperative relative expression of miR-24 was(1.15±0.36)%, which was prominently higher than preoperative(0.74 ±0.18)%(P <0.001). Multivariate linear regression analysis indicated that △miR-24 bore a positive relationship to △CDT, △SDMT and △CFT(P<0.05), while bore a negative relationship to △CFT(P<0.05).Conclusion For patients with carotid stenosis, stent implantation can significantly improve the cognitive function, which is mainly reflected in time orientation, spatial orientation, attention, visual spatial perception,etc. The mechanism may be related to the promotion of miR-24 expression.(J Intervent Radiol, 2021, 30:393-397)更多还原