MiR-137在缺血性卒中后抑郁患者外周血中的表达及其临床意义
发布时间：2018-10-18 12:37
【摘要】：背景脑卒中具有高致残率、高复发率、高致死率的特点,是目前世界第二大死因。随着我国人口老龄化进程的加快,我国脑卒中的发病率越来越高,尤其是在老年人群中,而且青年脑卒中患者也呈现出逐年上升的趋势。而脑卒中后抑郁作为脑卒中后最常见的心理行为障碍并发症,其发病率也越来越高。但是,目前关于脑卒中后抑郁的发病机制仍不十分明确,其治疗方案与原发性抑郁症的治疗几乎没有差别,主要包括单胺氧化酶抑制剂、三环类抗抑郁药、选择性5-羟色胺再摄入抑制剂、选择性去甲肾上腺素再摄取抑制剂。而单胺氧化酶抑制剂、三环类抗抑郁药由于其毒副作用大、不良反应多,治疗剂量与中毒剂量相近,目前已较少使用。选择性5-羟色胺再摄入抑制剂、选择性去甲肾上腺素再摄取抑制剂的可选择性也较少。随着生物分子学的发展,mi R-137对神经元、突触可塑性、血管再生等方面的作用逐渐浮出水面,因此,有望从分子生物学角度研究脑卒中后抑郁的形成机制,寻求治疗脑卒中后抑郁的新方法。目的探讨缺血性卒中后抑郁患者mi R-137的变化及临床意义。方法采用中国急性缺血性脑卒中诊治指南2014急性脑梗死诊断标准、汉密尔顿抑郁量表(HAMD 24项)、精神障碍诊断及统计手册第五版(DSM 5)将研究对象分为正常对照组、抑郁症组各20例,脑卒中后抑郁组、脑卒中组各37例。运用实时荧光定量PCR方法(qRT-PCR)检测各组miR-137的表达水平,并对相关结果进行比较。结果(1)四组样本的性别、年龄、合并高血压病、合并糖尿病、合并心脏病、NIHSS评分差异无统计学意义(均P0.05)。(2)脑卒中后抑郁组与脑卒中组之间左侧脑梗死的例数差异具有统计学意义,脑卒中后抑郁组与脑卒中组相比其左侧脑梗死例数明显增高(P0.05)。脑卒中组、脑卒中后抑郁组、抑郁症组与正常对照组相比miR-137水平明显降低(均P0.05);脑卒中后抑郁组与脑卒中组相比miR-137水平明显降低(P0.05);脑卒中后抑郁组、抑郁症组miR-137水平差异无统计学意义(P0.05)。结论(1)缺血性脑卒中会引起miR-137表达水平的下降,并且miR-137表达水平的下降参与缺血性卒中后抑郁的形成。mi R-137可以作为缺血性卒中后抑郁的预测、诊断及治疗指标。(2)脑卒中部位与PSD具有相关性,左侧大脑半球的卒中其PSD发病率可能更高。
[Abstract]:Background Stroke is the second leading cause of death in the world because of its high disability rate, high recurrence rate and high fatality rate. With the acceleration of population aging in China, the incidence of stroke in China is increasing, especially in the elderly population, and young stroke patients are also showing a rising trend year by year. Post-stroke depression is the most common complication of mental and behavioral disorders after stroke, and its incidence is increasing. However, at present, the pathogenesis of post-stroke depression is still not very clear, and there is almost no difference between the treatment regimen and primary depression, mainly including monoamine oxidase inhibitors, tricyclic antidepressants. Selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors. Monoamine oxidase inhibitors tricyclic antidepressants have been used less recently because of their large side effects and more adverse reactions. Selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors were also less selective. With the development of biomolecules, the effects of mi R-137 on neurons, synaptic plasticity and vascular regeneration have gradually emerged. Therefore, it is expected to study the mechanism of post-stroke depression from the molecular biological point of view. To seek a new treatment for post-stroke depression. Objective to investigate the changes and clinical significance of mi R-137 in patients with depression after ischemic stroke. Methods 2014 criteria for diagnosis and treatment of acute cerebral infarction, 24 items of Hamilton Depression scale (HAMD), and fifth edition of the Manual for the diagnosis and Statistics of Mental Disorder (DSM 5) were used to divide the subjects into normal control group according to Chinese guidelines for the diagnosis and treatment of Acute Ischemic Stroke. Depression group (n = 20), post-stroke depression group (n = 37) and stroke group (n = 37). Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of miR-137 in each group and the results were compared. Results (1) Sex, age, hypertension, diabetes mellitus in the four groups. There was no significant difference in NIHSS score between the two groups (P0.05). (2). There was significant difference in the number of patients with left cerebral infarction between the post-stroke depression group and the stroke group. The number of left cerebral infarction in post-stroke depression group was significantly higher than that in stroke group (P0.05). The level of miR-137 in stroke group, post-stroke depression group, depression group and normal control group was significantly lower than that in normal control group (P0.05); the level of miR-137 in post-stroke depression group was significantly lower than that in stroke group (P0.05); There was no significant difference in miR-137 level in depression group (P0.05). Conclusion (1) Ischemic stroke can induce the decrease of miR-137 expression, and the decrease of miR-137 expression may be involved in the formation of depression after ischemic stroke. Mi R-137 can be used as a predictor of post-ischemic depression. Diagnosis and treatment measures. (2) the location of stroke is correlated with PSD, and the incidence of PSD may be higher in the left hemisphere of cerebral apoplexy.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R749.4
[Abstract]:Background Stroke is the second leading cause of death in the world because of its high disability rate, high recurrence rate and high fatality rate. With the acceleration of population aging in China, the incidence of stroke in China is increasing, especially in the elderly population, and young stroke patients are also showing a rising trend year by year. Post-stroke depression is the most common complication of mental and behavioral disorders after stroke, and its incidence is increasing. However, at present, the pathogenesis of post-stroke depression is still not very clear, and there is almost no difference between the treatment regimen and primary depression, mainly including monoamine oxidase inhibitors, tricyclic antidepressants. Selective serotonin reuptake inhibitors, selective norepinephrine reuptake inhibitors. Monoamine oxidase inhibitors tricyclic antidepressants have been used less recently because of their large side effects and more adverse reactions. Selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors were also less selective. With the development of biomolecules, the effects of mi R-137 on neurons, synaptic plasticity and vascular regeneration have gradually emerged. Therefore, it is expected to study the mechanism of post-stroke depression from the molecular biological point of view. To seek a new treatment for post-stroke depression. Objective to investigate the changes and clinical significance of mi R-137 in patients with depression after ischemic stroke. Methods 2014 criteria for diagnosis and treatment of acute cerebral infarction, 24 items of Hamilton Depression scale (HAMD), and fifth edition of the Manual for the diagnosis and Statistics of Mental Disorder (DSM 5) were used to divide the subjects into normal control group according to Chinese guidelines for the diagnosis and treatment of Acute Ischemic Stroke. Depression group (n = 20), post-stroke depression group (n = 37) and stroke group (n = 37). Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of miR-137 in each group and the results were compared. Results (1) Sex, age, hypertension, diabetes mellitus in the four groups. There was no significant difference in NIHSS score between the two groups (P0.05). (2). There was significant difference in the number of patients with left cerebral infarction between the post-stroke depression group and the stroke group. The number of left cerebral infarction in post-stroke depression group was significantly higher than that in stroke group (P0.05). The level of miR-137 in stroke group, post-stroke depression group, depression group and normal control group was significantly lower than that in normal control group (P0.05); the level of miR-137 in post-stroke depression group was significantly lower than that in stroke group (P0.05); There was no significant difference in miR-137 level in depression group (P0.05). Conclusion (1) Ischemic stroke can induce the decrease of miR-137 expression, and the decrease of miR-137 expression may be involved in the formation of depression after ischemic stroke. Mi R-137 can be used as a predictor of post-ischemic depression. Diagnosis and treatment measures. (2) the location of stroke is correlated with PSD, and the incidence of PSD may be higher in the left hemisphere of cerebral apoplexy.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3;R749.4
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相关期刊论文 前4条
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