MiR-137在缺血性卒中后抑郁患者外周血中的表達(dá)及其臨床意義
發(fā)布時(shí)間：2018-10-18 12:37
【摘要】：背景腦卒中具有高致殘率、高復(fù)發(fā)率、高致死率的特點(diǎn),是目前世界第二大死因。隨著我國(guó)人口老齡化進(jìn)程的加快,我國(guó)腦卒中的發(fā)病率越來(lái)越高,尤其是在老年人群中,而且青年腦卒中患者也呈現(xiàn)出逐年上升的趨勢(shì)。而腦卒中后抑郁作為腦卒中后最常見的心理行為障礙并發(fā)癥,其發(fā)病率也越來(lái)越高。但是,目前關(guān)于腦卒中后抑郁的發(fā)病機(jī)制仍不十分明確,其治療方案與原發(fā)性抑郁癥的治療幾乎沒(méi)有差別,主要包括單胺氧化酶抑制劑、三環(huán)類抗抑郁藥、選擇性5-羥色胺再攝入抑制劑、選擇性去甲腎上腺素再攝取抑制劑。而單胺氧化酶抑制劑、三環(huán)類抗抑郁藥由于其毒副作用大、不良反應(yīng)多,治療劑量與中毒劑量相近,目前已較少使用。選擇性5-羥色胺再攝入抑制劑、選擇性去甲腎上腺素再攝取抑制劑的可選擇性也較少。隨著生物分子學(xué)的發(fā)展,mi R-137對(duì)神經(jīng)元、突觸可塑性、血管再生等方面的作用逐漸浮出水面,因此,有望從分子生物學(xué)角度研究腦卒中后抑郁的形成機(jī)制,尋求治療腦卒中后抑郁的新方法。目的探討缺血性卒中后抑郁患者mi R-137的變化及臨床意義。方法采用中國(guó)急性缺血性腦卒中診治指南2014急性腦梗死診斷標(biāo)準(zhǔn)、漢密爾頓抑郁量表(HAMD 24項(xiàng))、精神障礙診斷及統(tǒng)計(jì)手冊(cè)第五版(DSM 5)將研究對(duì)象分為正常對(duì)照組、抑郁癥組各20例,腦卒中后抑郁組、腦卒中組各37例。運(yùn)用實(shí)時(shí)熒光定量PCR方法(qRT-PCR)檢測(cè)各組miR-137的表達(dá)水平,并對(duì)相關(guān)結(jié)果進(jìn)行比較。結(jié)果(1)四組樣本的性別、年齡、合并高血壓病、合并糖尿病、合并心臟病、NIHSS評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。(2)腦卒中后抑郁組與腦卒中組之間左側(cè)腦梗死的例數(shù)差異具有統(tǒng)計(jì)學(xué)意義,腦卒中后抑郁組與腦卒中組相比其左側(cè)腦梗死例數(shù)明顯增高(P0.05)。腦卒中組、腦卒中后抑郁組、抑郁癥組與正常對(duì)照組相比miR-137水平明顯降低(均P0.05);腦卒中后抑郁組與腦卒中組相比miR-137水平明顯降低(P0.05);腦卒中后抑郁組、抑郁癥組miR-137水平差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論(1)缺血性腦卒中會(huì)引起miR-137表達(dá)水平的下降,并且miR-137表達(dá)水平的下降參與缺血性卒中后抑郁的形成。mi R-137可以作為缺血性卒中后抑郁的預(yù)測(cè)、診斷及治療指標(biāo)。(2)腦卒中部位與PSD具有相關(guān)性,左側(cè)大腦半球的卒中其PSD發(fā)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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：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.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3;R749.4
【參考文獻(xiàn)】
相關(guān)期刊論文 前4條
1 姚珊;沈霞;岳炫燁;;SLC6A4基因rs2020939多態(tài)性與卒中后抑郁相關(guān)性的研究[J];徐州醫(yī)學(xué)院學(xué)報(bào);2014年10期
2 錢方媛;張志s，
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