难治性癫痫患者神经调节蛋白1、microRNA-221-3p表达与认知功能的关系

庄婵芝; 潘志雄; 何素丽; 陈翔; 谢泽娟; 陈嘉迪; 何文贞

doi:10.7619/jcmp.20212229

难治性癫痫患者神经调节蛋白1、microRNA-221-3p表达与认知功能的关系

Relationships between expressions of serum neuregulin 1, microRNA-221-3p and cognitive function in patients with refractory epilepsy

摘要

摘要:
目的探讨难治性癫痫患者血清神经调节蛋白1（NRG1）、microRNA-221-3p（miR-221-3p）表达水平与认知功能障碍（CD）的关系。
方法选取64例难治性癫痫患者（难治性癫痫组）和58例抗癫痫药物控制良好患者（药物控制良好组）作为研究对象，另选取同期本院70例健康体检者纳入对照组。采用蒙特利尔认知评估量表（MoCA）评估难治性癫痫患者的认知功能受损程度，并根据MoCA总分将难治性癫痫患者分为CD组40例和非CD组24例。采用实时荧光定量PCR法检测血清miR-221-3p水平，采用酶联免疫吸附试验（ELISA）法检测血清NRG1水平，并采用Pearson相关性分析探讨miR-221-3p、NRG1水平与MoCA总分的相关性，采用多因素Logistic回归分析探讨难治性癫痫患者发生CD的影响因素。
结果难治性癫痫组血清miR-221-3p、NRG1水平高于对照组、药物控制良好组，差异有统计学意义（P < 0.05）；CD组血清miR-221-3p、NRG1水平高于非CD组，MoCA总分、空间与执行能力评分、语言评分、延迟记忆评分、计算力与定向评分低于非CD组，差异有统计学意义（P < 0.05）。Pearson相关性分析显示，难治性癫痫CD患者血清miR-221-3p、NRG1水平均与MoCA总分呈负相关（P < 0.05）。Logistic回归分析显示，NRG1、miR-221-3p均为难治性癫痫患者发生CD的影响因素（P < 0.05）。
结论难治性癫痫合并CD患者血清miR-221-3p、NRG1水平较高，且miR-221-3p、NRG1均与难治性癫痫患者CD进程密切相关。

Abstract:
Objective To explore the relationships between serum levels of microRNA-221-3p (miR-221-3p), neuregulin 1 (NRG1) and cognitive dysfunction (CD) in patients with refractory epilepsy.
Methods A total of 64 patients with refractory epilepsy (refractory epilepsy group) and 58 patients with well-controlled anti-epileptic drugs (anti-epileptic drugs well-controlled group) were selected as research objects. During the same period, 70 healthy patients in the same hospital were selected as control group. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the degree of cognitive impairment in patients with refractory epilepsy, and the patients with refractory epilepsy were divided into CD group (40 cases) and non-CD group (24 cases) according to the MoCA total score. Real-time fluorescent quantitative PCR method was used to detect the serum level of miR-221-3p, enzyme-linked immunosorbent assay (ELISA) was used to measure the serum level of NRG1, Pearson method was used to analyze the correlations between miR-221-3p, NRG1 levels and the total score of MoCA, multivariate Logistic regression was used to analyze the independent risk factors affecting the development of CD in patients with refractory epilepsy.
Results Compared with the control group and the anti-epileptic drugs well-controlled group, the serum miR-221-3p and NRG1 levels in the refractory epilepsy group were higher (P < 0.05); compared with the non-CD group, the serum miR-221-3p and NRG1 levels in the CD group were higher, and the MoCA total score, spatial and executive ability score, language score, delayed memory score, computing power and orientation score were lower (P < 0.05). Pearson correlation analysis showed that the serum levels of miR-221-3p and NRG1 were negatively correlated with the total score of MoCA(P < 0.05). Logistic regression analysis showed that NRG1 and miR-221-3p were risk factors for CD in patients with refractory epilepsy (P < 0.05).
Conclusion The patients with refractory epilepsy and CD have relatively higher levels of serum miR-221-3p and NRG1, and they are closely related to the progression of CD in patients with refractory epilepsy.

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