癫痫患者血浆miR-146a、miR-132表达水平与其认知及精神心理障碍关系的研究
发布时间：2018-07-21 20:11
【摘要】：目的癫痫是神经系统常见的疾病之一,随着生物医学模式的转变,癫痫共患认知及精神心理障碍等疾病引起人们越来越多的重视,其中认知功能障碍、焦虑和抑郁最为常见,癫痫共患病受多种因素的影响,但具体发病机制并未明确。研究表明,miR-146a、miR-132可以通过调节炎症反应或突触可塑性在癫痫病理生理性过程中起到关键性的作用,同时miR-146a、miR-132在认知或精神心理障碍的发病机制中也发挥重要的作用,但在癫痫共病认知功能障碍、焦虑和抑郁中,miR-146a、miR-132的表达变化目前尚无有关报道。本课题通过观察癫痫患者血浆miR-146a、miR-132的表达水平,研究其与癫痫相关影响因素及共病认知功能障碍、焦虑和抑郁的关系,为探求miRNA在癫痫共患病中的诊断价值提供理论依据。方法本实验共纳入75名受试对象,其中癫痫患者40例,对照组35例。对癫痫患者和健康对照行MoCA、HAMA及HAMD量表评估,同时采集癫痫组和对照组受试对象血浆标本。研究对象血浆miR-146a、miR-132的表达水平通过实时荧光定量PCR方法进行检测。结果1.癫痫组中共病认知功能障碍、焦虑及抑郁总的患病率为62.5%,其中认知功能障碍患病率47.5%,焦虑患病率40.0%,抑郁患病率42.5%;教育程度与癫痫共病认知功能障碍呈正相关,病程、持续时间、服药数量与癫痫共病认知功能障碍呈负相关;发作频率、持续时间、服药数量与癫痫共病焦虑呈正相关,教育程度与癫痫共病抑郁呈负相关,病程、服药数量与癫痫共病抑郁呈正相关。2.癫痫患者血浆miR-146a、miR-132的表达水平相对健康对照明显升高,其中以miR-132更为显著,低教育水平的癫痫患者,其血浆miR-146a、miR-132的表达明显上调,癫痫起病年龄较早,病程、发作持续时间较长的患者血浆miR-132上调明显,其中教育水平与miR-146a、miR-132呈负相关,病程、发作持续时间与miR-132呈正相关。3.癫痫共病认知功能障碍、焦虑及抑郁患者血浆中miR-146a、miR-132的表达水平相对无共患疾病的癫痫患者明显升高,同时伴随共患疾病种类的增加,血浆miR-146a、miR-132的含量也随之增加,其中miR-146a、miR-132与MoCA总分呈负相关,与共患疾病种类呈正相关,miR-132与HAMA总分、HAMD总分呈正相关,回归分析显示,血浆miR-132表达水平的升高是癫痫共病认知功能障碍、焦虑及抑郁的危险因素。结论1.癫痫患者中认知功能障碍、焦虑和抑郁普遍存;癫痫共病认知功能障碍、焦虑和抑郁受多方面因素影响,包括社会人口学因素(教育程度)、生物学因素(癫痫临床特征)、药物因素(AEDs)等。2.miR-146a、miR-132在癫痫患者中表达升高,miR-132能够反映癫痫疾病的严重程度,miR-146a、miR-132有成为癫痫诊断生物学标志物的潜能。3.miR-146a、miR-132能够反映癫痫共病认知功能障碍、焦虑及抑郁疾病的严重程度,miR-132能够预测癫痫共病认知功能障碍、焦虑及抑郁的风险,为癫痫共病认知功能障碍、焦虑及抑郁的临床诊断、风险评估及疗效评价提供理论依据。
[Abstract]:Objective epilepsy is one of the common diseases of the nervous system. With the transformation of the biomedical model, more and more attention has been paid to the cognitive and mental disorders of epilepsy, among which cognitive dysfunction, anxiety and depression are the most common, and the prevalence of epilepsy is affected by various factors, but the specific pathogenesis is not clear. It shows that miR-146a, miR-132 can play a key role in the pathophysiological process of epilepsy by regulating inflammatory response or synaptic plasticity, while miR-146a, miR-132 also plays an important role in the pathogenesis of cognitive or psycho mental disorders, but in the cognitive dysfunction of epilepsy, anxiety and depression, miR-146a, miR-132 There are no reports on the changes of expression at present. By observing the level of miR-146a and miR-132 expression in plasma of epileptic patients, the relationship between the related factors of epilepsy and the cognitive impairment, anxiety and depression is studied, and the theoretical basis of the diagnostic value of miRNA in the diagnosis of epilepsy is provided. Methods 75 subjects were included in this experiment. Subjects were 40 epileptic patients and 35 cases in control group. The MoCA, HAMA and HAMD scales of epileptic and healthy controls were evaluated, and plasma samples of epileptic and control subjects were collected. Plasma miR-146a, miR-132 expression level was detected by real-time fluorescence quantitative PCR method. Results the cognitive work of 1. epileptic groups was found. The total incidence of disability, anxiety and depression was 62.5%, of which the prevalence of cognitive dysfunction was 47.5%, the rate of anxiety was 40%, and the rate of depression was 42.5%. The education level was positively correlated with the cognitive dysfunction of the common disease, the duration of the disease, the duration of the disease, the number of medication and the dysfunction of the common disease recognition dysfunction; the frequency, duration, and medication of the seizures. There was a positive correlation between the number and the common disease anxiety of epilepsy, the degree of education was negatively related to the common disease and depression, the course of disease, the number of drugs and the common disease depression were positively correlated with miR-146a in.2. epileptic patients, and the expression level of miR-132 was significantly higher than that of the healthy control. Among them, miR-132 was more significant, the low education level of epileptic patients, and their plasma miR-146a, The expression of miR-132 was obviously up-regulated, the age of the onset of epilepsy was earlier, the course of the disease and the longer duration of the seizures were obviously up-regulated in plasma miR-132, and the educational level was negatively correlated with miR-146a and miR-132. The course of disease, the duration of the attack and the miR-132 were positively related to the cognitive disability of.3., and the miR-146a, miR-132 in the plasma of the patients with anxiety and depression. The level of expression of miR-146a and miR-132 in plasma increased with the increase of the species of codeveloped disease, and miR-146a, miR-132 and MoCA were negatively correlated with the type of CO developed disease, and the total score of miR-132 and HAMA, HAMD total score was positively correlated, regression analysis showed blood. The increase in plasma miR-132 expression level is a risk factor for cognitive impairment, anxiety and depression in the patients with epilepsy. Conclusion 1. the cognitive impairment, anxiety and depression generally exist in epileptic patients; the cognitive impairment of epilepsy, anxiety and depression are influenced by many factors, including social demographic factors (Education), and biological factors (epilepsy). Clinical features), drug factors (AEDs) and other.2.miR-146a, miR-132 expression in epileptic patients, miR-132 can reflect the severity of epilepsy, miR-146a, miR-132 has the potential to become a biological marker of epilepsy,.3.miR-146a, miR-132 can reflect the cognitive impairment of epilepsy, the severity of anxiety and depression, miR- 132 can predict the risk of cognitive dysfunction, anxiety and depression in epileptic comorbidity, and provide a theoretical basis for the clinical diagnosis of the cognitive impairment of CO disease, the clinical diagnosis of anxiety and depression, the risk assessment and the evaluation of the curative effect.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1
本文编号：2136721
[Abstract]:Objective epilepsy is one of the common diseases of the nervous system. With the transformation of the biomedical model, more and more attention has been paid to the cognitive and mental disorders of epilepsy, among which cognitive dysfunction, anxiety and depression are the most common, and the prevalence of epilepsy is affected by various factors, but the specific pathogenesis is not clear. It shows that miR-146a, miR-132 can play a key role in the pathophysiological process of epilepsy by regulating inflammatory response or synaptic plasticity, while miR-146a, miR-132 also plays an important role in the pathogenesis of cognitive or psycho mental disorders, but in the cognitive dysfunction of epilepsy, anxiety and depression, miR-146a, miR-132 There are no reports on the changes of expression at present. By observing the level of miR-146a and miR-132 expression in plasma of epileptic patients, the relationship between the related factors of epilepsy and the cognitive impairment, anxiety and depression is studied, and the theoretical basis of the diagnostic value of miRNA in the diagnosis of epilepsy is provided. Methods 75 subjects were included in this experiment. Subjects were 40 epileptic patients and 35 cases in control group. The MoCA, HAMA and HAMD scales of epileptic and healthy controls were evaluated, and plasma samples of epileptic and control subjects were collected. Plasma miR-146a, miR-132 expression level was detected by real-time fluorescence quantitative PCR method. Results the cognitive work of 1. epileptic groups was found. The total incidence of disability, anxiety and depression was 62.5%, of which the prevalence of cognitive dysfunction was 47.5%, the rate of anxiety was 40%, and the rate of depression was 42.5%. The education level was positively correlated with the cognitive dysfunction of the common disease, the duration of the disease, the duration of the disease, the number of medication and the dysfunction of the common disease recognition dysfunction; the frequency, duration, and medication of the seizures. There was a positive correlation between the number and the common disease anxiety of epilepsy, the degree of education was negatively related to the common disease and depression, the course of disease, the number of drugs and the common disease depression were positively correlated with miR-146a in.2. epileptic patients, and the expression level of miR-132 was significantly higher than that of the healthy control. Among them, miR-132 was more significant, the low education level of epileptic patients, and their plasma miR-146a, The expression of miR-132 was obviously up-regulated, the age of the onset of epilepsy was earlier, the course of the disease and the longer duration of the seizures were obviously up-regulated in plasma miR-132, and the educational level was negatively correlated with miR-146a and miR-132. The course of disease, the duration of the attack and the miR-132 were positively related to the cognitive disability of.3., and the miR-146a, miR-132 in the plasma of the patients with anxiety and depression. The level of expression of miR-146a and miR-132 in plasma increased with the increase of the species of codeveloped disease, and miR-146a, miR-132 and MoCA were negatively correlated with the type of CO developed disease, and the total score of miR-132 and HAMA, HAMD total score was positively correlated, regression analysis showed blood. The increase in plasma miR-132 expression level is a risk factor for cognitive impairment, anxiety and depression in the patients with epilepsy. Conclusion 1. the cognitive impairment, anxiety and depression generally exist in epileptic patients; the cognitive impairment of epilepsy, anxiety and depression are influenced by many factors, including social demographic factors (Education), and biological factors (epilepsy). Clinical features), drug factors (AEDs) and other.2.miR-146a, miR-132 expression in epileptic patients, miR-132 can reflect the severity of epilepsy, miR-146a, miR-132 has the potential to become a biological marker of epilepsy,.3.miR-146a, miR-132 can reflect the cognitive impairment of epilepsy, the severity of anxiety and depression, miR- 132 can predict the risk of cognitive dysfunction, anxiety and depression in epileptic comorbidity, and provide a theoretical basis for the clinical diagnosis of the cognitive impairment of CO disease, the clinical diagnosis of anxiety and depression, the risk assessment and the evaluation of the curative effect.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1
【参考文献】
相关期刊论文 前1条
1 叶玉勤;苏鑫洪;贺晓生;;microRNA-132调控突触可塑性的作用研究[J];中华神经外科疾病研究杂志;2016年05期
，本文编号：2136721
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