罗玮;刘玲;戴丽星;曾华;

• 1:江汉大学附属湖北省第三人民医院全科医学科
• 2:湖北省中医院脑病科
• 3:武汉市中医医院肛肠科

摘要(Abstract)：

目的 观察卒中后认知障碍(PSCI)患者血清微小RNA(miRNAs)表达谱，验证目标miRNAs组合的表达情况及加味涤痰汤对其影响。方法 通过高通量测序方式测定PSCI患者及对照组(脑卒中后无认知障碍组和正常人组)血清miRNA表达情况，筛选与PSCI发病过程密切相关差异表达的miRNAs组合进行研究。收集30例PSCI患者给予加味涤痰汤口服，观察疗程8周，另收集同期认知功能正常的老年健康体检者30例作为对照组。采用荧光定量PCR法检测PSCI患者治疗前后及对照组血清目标 miRNAs的水平。结果 对筛选的20个差异miRNAs进行研究。与对照组比较，PSCI组治疗前血清miR-31、miR-93、miR-143、miR-146a、miR-107、miR-126表达显著升高(P<0.05)，miR-29a，miRNA-34a表达显著降低(P<0.05)。与治疗前比较，PSCI组治疗后血清miR-29a、miRNA-34a表达升高(P<0.05)，miR-31、miR-93、miR-143、miR-146a、miR-126表达显著降低(P<0.05)，miR-107表达降低(P<0.05)。结论 通过检测血清miR-31、miR-93、miR-143、miR-146a、miR-107、miR-126及miR-29a、miRNA-34a表达水平可能有助于PSCI患者的早期诊断；加味涤痰汤能升高PSCI患者外周血血清miR-29a、miRNA-34a的水平，显著降低miR-31、miR-93、miR-143、miR-146a、miR-126的水平，使miR-107水平降低。

关键词(KeyWords)： 卒中后认知障碍;miRNA组合;加味涤痰汤;早期诊断

Abstract:

Keywords:

基金项目(Foundation): 国家自然基金面上项目(81273648)

作者(Authors): 罗玮;刘玲;戴丽星;曾华;

DOI: 10.13463/j.cnki.jlzyy.2022.03.013

参考文献(References)：

• [1]董强,郭起浩,罗本燕,等.卒中后认知障碍管理专家共识[J].中国卒中杂志，2017,12(6):519-531.
• [2]黄雨滟,彭博,陈颖异,等.卒中后认知障碍管理的最佳证据总结[J].护理研究，2020,34(21):3752-3758.
• [3]QI D Y,LIU L R.Research progress on biomarkers of cognitive dysfunction after stroke[J].Stroke and Nervous Diseases,2020,27(6):856-859.
• [4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志，2010,43(2):146-152.
• [5]中华医学会神经病学分会痴呆与认知障碍学组写作组.血管性认知障碍诊治指南[J].中华神经科杂志，2011,44(2):142-147.
• [6]田金洲,韩明向,涂晋文,等.血管性痴呆的诊断、辨证及疗效判定标准[J].北京中医药大学学报，2000,23(5):16-24.
• [7]易全民,漆琼蔚,刘璐,等.血清miR-222和miR-206水平与女性阿尔茨海默病患者认知和运动功能的关系及其在诊断中的价值[J].临床精神医学杂志，2019,29(4):254-257.
• [8]BERNSTEIN D L,GAJGHATE S,REICHENBACH N L,et al.Let-7g counteracts endothelial dysfunction and ameliorating neurological functions in mouse ischemia/reperfusion stroke model[J].Brain Behavior and Immunity,2020,87:543-555.
• [9]WEI P B,CHEN H,LIN B,et al.Inhibition of the BCL6/miR-31/PKD1 axis attenuates oxidative stress-induced neuronal damage[J].Experimental Neurology,2020.
• [10]MA Q,LI G,TAO Z,et al.Blood microRNA-93 as an indicator for diagnosis and prediction of functional recovery of acute stroke patients[J].Journal of Clinical Neuroscience,2018.
• [11]WANG P,LIANG X,LU Y,et al.MicroRNA-93 downregulation ameliorates cerebral ischemic injury through the Nrf2/HO-1 defense pathway[J].Neurochemical Research,2016,41(10):1-9.
• [12]VINCIGUERRA A,CEPPARULO P,ANZILOTTI S,et al.Remote postconditioning ameliorates stroke damage by preventing let-7a and miR-143 up-regulation[J].Theranostics,2020,10(26):12174-12188.
• [13]薄纯锐，王丽华，王健健.MiR-146a在神经系统疾病中的作用及研究进展[J].中国神经免疫学和神经病学杂志，2017,24(6):421-425.
• [14]ABOLFATHI H,SHEIKHPOUR M,SOLTANI B M,et al.The comparison and evaluation of the miR-16,miR-155 and miR-146a expression pattern in the blood of TB and NSCLC patients:A research paper[J].Gene Reports,2021,22:100967.
• [15]YANG J,MALONE F,GO M,et al.Lipopolysaccharide-induced exosomal miR-146a is involved in altered expression of Alzheimer’s risk genes via suppression of TLR4 signaling[J].Journal of Molecular Neuroscience,2020:1-11.
• [16]YANG Z B,LI T B,ZHANG Z,et al.The diagnostic value of circulating brain-specific microRNAs for ischemic stroke[J].Internal Medicine,2016,55(10):1279.
• [17]QI R,LIU H,LIU C,et al.Expression and short-term prognostic value of miR-126 and miR-182 in patients with acute stroke[J].Experimental and Therapeutic Medicine,19(1).
• [18]GAI H Y,WU C,ZHANG Y,et al.Long non-coding RNA CHRF modulates the progression of cerebral ischemia/reperfusion injury via miR-126/SOX6 signaling pathway[J].Biochemical & Biophysical Research Communications,2019,514(2):550.
• [19]GENG W,TANG H,LUO S,et al.Exosomes from miRNA-126-modified ADSCs promotes functional recovery after stroke in rats by improving neurogenesis and suppressing microglia activation[J].American Journal of Translational Research,2019.
• [20]GAO J,YANG S N,WANG K,et al.Plasma miR-126 and miR-143 as potential novel biomarkers for cerebral atherosclerosis[J].Journal of Stroke and Cerebrovascular Diseases:the official journal of National Stroke Association,2018.
• [21]段志胜,刘子由,谢和平,等.miR-29a抑制血管内皮细胞增殖的机制研究[J].中国临床药理学杂志，2020,36(18):2803-2805,2813.
• [22]ZHAO M M,GAO J L,ZHANG Y N,et al.Elevated miR-29a contributes to axonal outgrowth and neurological recovery after intracerebral hemorrhage via targeting PTEN/PI3K/Akt pathway[J].Cellular and Molecular Neurobiology,2020(6).
• [23]CHOI G H,KO K H,KIM J O,et al.Association of miR-34a,miR-130a,miR-150 and miR-155 polymorphisms with the risk of ischemic stroke[J].International Journal of Molecular Medicine,2016,38(1):345.
• [24]JINLI,WANG,YUAN,et al.Inhibition of microRNA-34a suppresses epileptiform discharges through regulating notch signaling and apoptosis in cultured hippocampal neurons[J].Neurochemical Research,2019.
• [25]邹东华，张千，黄芳，等.miRNA-34a在阿尔茨海默病APP/PS1小鼠模型发病机制研究[P].南宁市第一人民医院，2019-01-21.
• [26]李玉娟，谢道俊，周磊.基于数据挖掘中药治疗卒中后认知障碍用药规律探析[J].中药药理与临床，2020,36(5):211-215.
• [27]周黎，刘玲，潘微，等.加味涤痰汤对血管性轻度认知功能障碍大鼠海马神经递质及神经营养因子影响的研究[J].辽宁中医杂志，2020,47(4):195-197.
• [28]周黎，黄金元，赵雅靓，等.加味涤痰汤对血管性轻度认知功能障碍大鼠脑皮质IL-6,TNF-α及NO,NOS的影响[J].河南中医，2019,39(10):1511-1514.