【摘要】 目的 探究急性缺血性脑卒中患者血清中微小RNA-26a-5p(miR-26a-5p)、血清溶质载体家族7成员11(SLC7A11)水平与认知功能障碍的相关性。方法 选择齐齐哈尔市第一医院2023年5月至2025年5月收治的急性缺血性脑卒中患者125例为研究对象，并依据蒙特利尔认知评价(MoCA)量表，对其发病是否出现认知功能障碍分为认知障碍组(MoCA评分<26分，n=43)与非认知障碍组(MoCA评分≥26分，n=82);对比血清中miR-26a-5p、SLC7A11表达水平，行多因素Logistic回归分析影响患者发生认知功能障碍的相关因素；用Spearman秩相关分析确定血清中miR-26a-5p、SLC7A11表达水平与认知功能障碍的相关性，绘制ROC曲线分析血清中miR-26a-5p、SLC7A11对认知功能障碍的预测价值。结果 认知障碍组患者高血压史、糖尿病史、高血脂史占比较高，肿瘤坏死因子α(TNF-α)、血清超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、活性氧(ROS)水平均明显高于非认知障碍组，差异有统计学意义(P<0.05);认知障碍组与非认知障碍组比较，SLC7A11水平下降，miR-26a-5p水平升高，差异有统计学意义(P<0.05);多因素Logistic分析显示，TNF-α、hs-CRP、ROS、miR-26a-5p、IL-1β、SLC7A11是影响急性缺血性脑卒中患者发生认知功能障碍的危险因素；Spearman秩相关分析，认知功能障碍与miR-26a-5p呈正相关，与SLC7A11呈负相关；ROC曲线分析显示，miR-26a-5p、SLC7A11联合检测效能高于单项检测，差异有统计学意义(P<0.05)。结论 血清miR-26a-5p、SLC7A11是患者发生认知功能障碍的风险因素，联合检测对认知功能障碍有较高预测效能。更多还原

【Abstract】 Objective To investigate the levels of microRNA-26a-5p(miR-26a-5p) and solute carrier family 7 member 11(SLC7A11) in the serum of acute ischemic stroke patients and their correlation with cognitive dysfunction.Methods A total of 125 patients with acute ischemic stroke admitted to the First Hospital of Qiqihar from May 2023 to May 2025 were selected as the study subjects.Based on the Montreal Cognitive Assessment(MoCA) scale, they were divided into a cognitive dysfunction group(MoCA score <26,n=43) and a non-cognitive dysfunction group(MoCA score ≥26,n=82).The serum levels of miR-26a-5p and SLC7A11 were compared, and multivariate logistic regression analysis was performed to identify factors influencing cognitive dysfunction.Spearman rank correlation was used to determine the correlation between serum miR-26a-5p, SLC7A11 levels and cognitive dysfunction, and ROC curves were plotted to analyze the predictive value of serum miR-26a-5p and SLC7A11 for cognitive dysfunction.Results The cognitive dysfunction group had a higher prevalence of hypertension, diabetes, and hyperlipidemia history, and significantly higher levels of tumor necrosis factor-alpha(TNF-α),serum high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),and reactive oxygen species(ROS) compared to the non-cognitive dysfunction group, with statistically significant differences(P<0.05).Compared between the two groups, the SLC7A11 level decreased while the miR-26a-5p level increased, with statistically significant differences(P<0.05).Multivariate logistic analysis showed that TNF-α,hs-CRP,ROS,miR-26a-5p, IL-1β,and SLC7A11 were risk factors for cognitive dysfunction in patients with acute ischemic stroke.Spearman rank correlation analysis revealed a positive correlation between cognitive dysfunction and miR-26a-5p, and a negative correlation with SLC7A11.ROC curve analysis demonstrated that the combined detection of miR-26a-5p and SLC7A11 had higher predictive efficacy than individual detection, with statistically significant differences(P<0.05).Conclusion Serum miR-26a-5p and SLC7A11 are risk factors for cognitive dysfunction in patients, and their combined detection has high predictive efficacy for cognitive dysfunction.更多还原