腔隙性脑梗死伴脑白质病变患者血清miR-146a和NSE水平与MoCA评分的关系研究

摘要 目的：研究腔隙性脑梗死（LI）伴脑白质病变（WML）患者血清miR-146a和神经元特异性烯纯化酶（NSE）水平与蒙特利尔认知评估量表（MoCA）评分的关系。方法：纳入我院从2017年3月～2019年3月收治的LI伴WML患者108例进行研究，记作LI伴WML组。另取同期收治的单纯WML患者与单纯LI患者各100例，分别记作WML组与LI组，再取同期于我院进行体检的健康人员100例作为对照组。比较四组人员的血清miR-146a和NSE水平、MoCA评分，并作相关性分析。结果：LI伴WML组、WML组、LI组血清miR-146a相对表达量均低于对照组，而LI伴WML组血清miR-146a相对表达量又显著低于WML组、LI组（均P＜0.05）；LI伴WML组、WML组、LI组血清NSE水平均显著高于对照组，且LI伴WML组血清NSE水平均显著高于WML组、LI组（均P＜0.05）。LI伴WML组MoCA总分显著低于WML组与LI组，且WML组与LI组MoCA总分显著低于对照组（均P＜0.05）。经Pearson相关性分析可得：LI伴WML组患者血清miR-146a相对表达量与MoCA总分呈正相关关系（P＜0.05），而血清NSE水平与MoCA总分呈负相关关系（P＜0.05）。结论：LI伴WML患者的血清miR-146a水平存在明显低表达，而NSE水平存在明显高表达，并与MoCA评分相关，两者可能在认知功能损伤的发生、发展过程中起着至关重要的作用。

Relationship between Serum miR-146a and NSE Levels and MoCA Score in Patients with Lacunar Infarction with Leukoencephalopathy

ABSTRACT Objective: To study the relationship between serum miR-146a and neuron-specific ene purification enzyme (NSE) levels and Montreal cognitive assessment scale (MoCA) scores in patients with lacunar cerebral infarction (LI) with leuboencephalopathy (WML). Methods: 108 patients with LI and WML who were admitted to our hospital from March 2017 to March 2019 were included in the study, and were recorded as the LI with WML group. In addition, 100 cases of WML patients and 100 cases of LI patients who were admitted at the same time were recorded as WML group and LI group, and 100 cases of healthy people who underwent physical examination in our hospital at the same time were taken as the control group. Serum miR-146a and NSE levels and MoCA scores of the four groups were compared, and the correlation was analyzed. Results: The relative expression of serum miR-146a in the LI with WML group, WML group and LI group were lower than that in the control group, while the relative expression of serum miR-146a in the LI with WML group were significantly lower than that in the WML group and LI group (all P<0.05). The serum NSE level of the LI with WML group, WML group and LI group were significantly higher than that in the control group, and the serum NSE level of the LI with WML group were significantly higher than that in the WML group and LI group (all P<0.05). The total MoCA score of the LI with WML group were significantly lower than that in the WML group and LI group, and the total MoCA score of the WML group and the LI group were significantly lower than that in the control group (all P<0.05). Pearson correlation analysis showed that the relative expression of serum miR-146a in the LI with WML group was positively correlated with the total MoCA score (P<0.05), while the serum NSE level was negatively correlated with the total MoCA score (P<0.05). Conclusion: Serum miR-146a level in LI with WML patients is significantly lower, while the serum NSE level is significantly higher, and they are correlated with MoCA score, which may play a crucial role in the occurrence and development of cognitive impairment.