薛玉峰 叶丽君 傅攀

[摘要] 目的 探讨miR-135a和miR-146a在阿尔茨海默病（AD）患者中的表达及临床意义，为AD的诊断提供依据。 方法 选取2017年6月—2019年5月浙江省台州市第一人民医院（以下简称“我院”）神经内科住院的65例AD患者为AD组，另选取同期在我院体检的30名健康体检者作为对照组。采用实时荧光定量PCR检测miR-135a和miR-146a表达水平，受试者工作特征（ROC）曲线评价miR-135a和miR-146a对AD诊断效能。 结果 AD组miR-135a表达低于对照组，miR-146a表达高于对照组，差异均有统计学意义（均P < 0.05）。miR-135a诊断AD的临界值为0.825，敏感度为0.923，特异性为0.700;miR-146a诊断AD的临界值为2.065，敏感度为0.877，特异性为0.900。 结论 AD患者中miR-135a表达下调，miR-146a表达上调，对AD有较高的诊断效能。

[关键词] 阿尔茨海默病;miR-135a;miR-146a;表达

[中图分类号] R749.16          [文献标识码] A          [文章编号] 1673-7210（2020）08（b）-0016-04

[Abstract] Objective To investigate the expression and clinical significance of miR-135a and miR-146a in patients with Alzheimer′s disease （AD）， and to provide evidence for the diagnosis of AD. Methods Sixty-five patients with AD who admitted to Department of Neurology， the First People′s Hospital of Taizhou of Zhejiang Province （“our hospital”for short） from June 2017 to May 2019 were enrolled in AD group. In addition， 30 healthy subjects who underwent physical examination in our hospital during the same period were selected as control group. The expression levels of miR-135a and miR-146a were detected by real-time fluorescent quantitative PCR and the diagnostic efficacy of miR-135a and miR-146a in AD were evaluated by receiver operating characteristic （ROC） curve. Results The expression of miR-135a in AD group was lower than that in control group， and the expression of miR-146a was higher than that in control group， with statistically significant differences （all P < 0.05）. The cut-off value of miR-135a in the diagnosis of AD was 0.825， the sensitivity was 0.923， and the specificity was 0.700. The cut-off value of miR-146a in the diagnosis of AD was 2.065， the sensitivity was 0.877， and the specificity was 0.900. Conclusion The expression of miR-135a is down-regulated， the expression of miR-146a is up-regulated in AD patients， which have a higher diagnostic efficacy for AD.

[Key words] Alzheimer′s disease; MiR-135a; MiR-146a; Expression

阿爾茨海默病（AD）是一种进行性神经系统退行性疾病，起病隐匿，临床症状通常表现为记忆障碍、失语、失认、执行功能障碍、视空间技能损害及行为和人格改变等的全面性痴呆，病因未明。随着我国人口老龄化越来越严重，AD发病率有增加趋势，给社会带来越来越重的负担，因此，对AD的早期诊疗有重要意义[1]。微小核糖核酸（miRNA）是由18～25个核苷酸组成的内源性非编码RNA，在中枢神经系统中表达，参与调节神经元分化，突触和神经突的可塑性增长，与AD的发病机制有关[2]。本研究旨在探讨miR-135a和miR-146a在AD患者中的表达及临床意义。

1 资料与方法

1.1 一般资料

选取2017年6月—2019年5月浙江省台州市第一人民医院（以下简称“我院”）神经内科住院的65例AD患者为AD组，同期选取我院30名健康体检者为对照组。

纳入标准：①参考《精神病诊断和统计手册》[3]的诊断标准;②年龄61～90岁;③记忆能力或认知功能下降≥6个月;④受教育年限≥5年。排除标准：①合并严重的心脑血管、肝脏、肾脏等疾病者;②精神病患者;③依从性差者。……