【摘要】 目的 探讨糖尿病（DM）合并急性脑卒中（AS）患者血清miRNA-126a、miRNA-130b水平与认知障碍（CI）的关系。方法 对武汉市第一医院2019年1月至2021年12月收治的70例DM合并AS患者进行回顾性分析。根据是否发生CI，将患者分为CI组（n=41）和非CI组（n=29）。通过实时荧光定量PCR检测miRNA-126a、miRNA-130b在外周血中的相对表达水平。结果 与非CI组比较，CI组的白蛋白增大（P<0.05）,miRNA-126a、miRNA-130b表达水平降低（P<0.05）。Logistic回归分析显示，白蛋白（OR=19.045,95%CI=2.001～181.230）、miRNA-126a(OR=200.603,95%CI=15.663～2 569.162)、miRNA-130b(OR=11.770,95%CI=1.966～70.474)是影响DM合并AS患者CI发生的相关因素。ROC曲线检测外周血中miRNA-126a诊断DM合并AS患者CI发生具有最高的AUC(0.958)，灵敏度和特异度分别为97.6%和89.7%。miRNA-130b诊断DM合并AS患者CI发生的AUC(0.669)较低，灵敏度和特异度分别为73.2%和62.1%。结论 外周血miRNA-126a表达降低对DM合并AS患者的CI具有良好的诊断价值。更多还原

【Abstract】 Objective To explore the relationship between serum miRNA-126a,miRNA-130b levels and cognitive impairment(CI) in patients with diabetes mellitus(DM) complicated with acute stroke(AS). Methods A retrospective analysis was conducted on 70 DM patients with AS admitted to Wuhan First Hospital from January 2019 to December 2021. Patients were divided into CI group(41 cases) and non-CI group(29 cases) based on the occurrence of CI. Real-time fluorescence quantitative PCR was used to detect the relative expression levels of miRNA-126a and miRNA-130b in peripheral blood. Results Compared with non-CI group,the CI group showed increased albumin( P < 0.05) and decreased levels of miRNA-126a and miRNA-130b( P < 0.05). Logistic regression analysis showed that albumin(OR = 19.045,95%CI = 2.001～181.230),miRNA-126a(OR = 200.603,95%CI = 15.663 ～ 2 569.162), miRNA-130b( OR = 11.770, 95%CI = 1.966 ～70.474) were related factors affecting CI occurrence in DM patients with AS. ROC curve analysis showed that peripheral blood miRNA-126a had t he highest AUC(0.958) for diagnosing CI in DM patients with AS,with a sensitivity of 97.6% and specificity of89.7%. The AUC for miRNA-130b( 0.669) was lower, with a sensitivity of 73.2% and specificity of 62.1%.Conclusion Decreased expression of peripheral blood miRNA-126a has good diagnostic value for CI in DM patients with AS.更多还原