Abstract: Objective To explore the expression level and clinical significance of plasma exosomalmiR-92a-5pand miR-532-5p in elderly patients with vascular cognitive impairment (VCI).Methods ixty patients with VCI were admitted to our hospital from January 2021 to October 2022,including 30 patients with mild V C I (mild group) and severe V C I (severe group),and 30 healthy patients were selected as controls (control group).Plasma exosomalmiR-92a-5p and miR-532-5p expression levels were determined by the RT-PCR assay.Plasma levels of neurotrophic factor (BDNF),glial fiber acidic protein (GFAP) and homocysteine (Hcy) were measured by an enzyme-linked immunosorbent assay.Correlation tests use Pearson analysis;the subject operating characteristic curve (ROC) analyzes the value of miR-92a-5p and miR-532-5p to diagnose VCI,calculates the area under the curve (AUC).Results The MoCA score miR-532-5p,and BDNF level in mild group and severe group were lower than control group (P＜0.05),while the levels of miR-92a-5p,GFAP and Hcy were higher than control group (P＜0.05).Compared with the mild group,the severe group had lower MoCA score,miR-532-5p,and BDNF level (P＜0.05),but higher miR-92a-5p,GFAP and Hcy levels (P＜0.05).In mild group and severe group,miR-92a-5p was negatively correlated with MoCA score and BDNF respectively (P＜0.05),and positively correlated with GFAP and Hcy respectively (P＜0.05);miR-532-5p was positively correlated with MoCA score and BDNF (P＜0.05),but negatively correlated with GFAP and Hcy (P＜0.05).There was a negative correlation between miR-92a-5p and miR-532-5p (P＜0.05).The AUC of miR-92a-5p and miR-532-5p in diagnosing VCI was 0.794 and 0.726 respectively,and the AUC of miR-92a-5p and miR-532-5p combined could be increased to 0.891.Conclusion The level of miR-92a-5p in plasma exocrine increased and the level of miR-532-5p decreased in elderly patients with VCI,thetwo index may be potential diagnostic markers.

Key words: Vascular cognitive impairment, Plasma, Exosomes, MicroRNAs, Diagnosis

摘要： 目的 探讨老年血管性认知障碍(VCI)患者血浆外泌体miR-92a-5p和miR-532-5p的表达水平及临床意义。方法 选取2021年1月至2022年10月本院收治的VCI患者60例,其中轻度VCI30例(轻度组)、重度VCI30例(重度组),另选取健康人30例为对照(对照组)。用RT-PCR法检测血浆外泌体miR-92a-5p和miR-532-5p表达水平。检测血浆神经营养因子(BDNF)、胶质纤维酸性蛋白(GFAP)/同型半胱氨酸(Hcy)水平。相关性检验用Pearson分析;受试者工作特征曲线(ROC)分析miR-92a-5p和miR-532-5p诊断VCI的价值,计算曲线下面积(AUC)。结果 与对照组比较,轻度组和重度组MoCA评分、miR-532-5p、BDNF水平较低(P＜0.05),而miR-92a-5p、GFAP、Hcy水平较高(P＜0.05)。与轻度组比较,重度组MoCA评分、miR-532-5p、BDNF水平较低(P＜0.05),而miR-92a-5p、GFAP、Hcy水平较高(P＜0.05)。在轻度组、重度组中,miR-92a-5p分别与MoCA评分、BDNF呈负相关(P＜0.05),而分别与GFAP、Hcy呈正相关(P＜0.05);miR-532-5p分别与MoCA评分、BDNF呈正相关(P＜0.05),而分别与GFAP、Hcy呈负相关(P＜0.05);miR-92a-5p与miR-532-5p呈负相关(P＜0.05)。miR-92a-5p、miR-532-5p诊断VCI的AUC分别为0.794、0.726,二者联合可将AUC提高至0.891。结论 老年VCI患者血浆外泌体miR-92a-5p水平升高、miR-532-5p水平下降,二者可能成为潜在的诊断标志物。

关键词: 血管性认知障碍, 血浆, 外泌体, 微小RNA, 诊断