摘要
目的探讨血浆微小RNA-155(miR-155)、微小RNA-195(miR-195)水平诊断首发精神分裂症执行功能障碍的诊断价值及交互作用。方法选取2020年6月至2023年6月商丘市第二人民医院收治的105例首发精神分裂症患者作为观察组,按照1∶1配对原则,另选取同期无精神分裂症体检志愿者105例作为对照组。比较两组受检者的血浆miR-155、miR-195水平,同时比较观察组有无执行功能障碍患者的执行缺陷综合征行为评价(BADS)评分及血浆miR-155、miR-195水平,采用受试者工作特征曲线(ROC)分析血浆miR-155、miR-195水平对执行功能障碍的诊断价值,采用Pearson法分析血浆miR-155、miR-195水平与BADS评分的相关性,通过交互作用分析上述指标对首发精神分裂症执行功能障碍发生的影响。结果观察组患者的血浆miR-155、miR-195水平分别为1.88±0.54、1.93±0.37,明显高于对照组的0.98±0.30、1.06±0.15,差异均有统计学意义(P<0.05);有执行功能障碍患者的卡片测验、动作计划测验、找钥匙测验、时间判断、动物园路线、修订六元素测试评分、BADS总分分别为(2.02±0.25)分、(1.21±0.14)分、(1.13±0.10)分、(1.54±0.19)分、(0.86±0.22)分、(1.40±0.28)分、(8.16±0.41)分,明显低于无执行功能障碍患者的(3.55±0.14)分、(3.36±0.18)分、(3.43±0.15)分、(3.48±0.16)分、(3.29±0.20)分、(3.40±0.12)分、(20.51±1.03)分,血浆miR-155、miR-195水平分别为2.07±0.31、2.15±0.33,明显高于无执行功能障碍患者的1.78±0.24、1.81±0.20,差异均有统计学意义(P<0.05);经Pearson法分析结果显示,血浆miR-155、miR-195与卡片测验、动作计划测验、找钥匙测验、时间判断、动物园路线、修订六元素测试评分、BADS总分均呈负相关(P<0.05);经ROC分析结果显示,血浆miR-155、miR-195联合诊断首发精神分裂症患者执行功能障碍的AUC为0.911(95%CI:0.839~0.957),约登指数为0.742,敏感度为91.89%,特异度为82.35%;经交互作用分析结果显示,miR-155阳性表达与miR-195阳性表达在首发精神分裂症患者执行功能障碍中呈正向交互作用(32.178<7.572×11.357,为次相乘模型)(P<0.05)。结论血浆miR-155、miR-195水平与首发精神分裂症执行功能障碍发生密切相关,且两指标阳性在执行功能障碍发生过程中呈正向交互作用,联合检测对执行功能障碍具有一定诊断价值。
Objective To investigate the diagnostic value and interaction of plasma microRNA-155(miR-155)and microRNA-195(miR-195)levels in the diagnosis of executive dysfunction in first-episode schizophrenia.Methods A total of 105 patients with first-episode schizophrenia admitted to Shangqiu Second People's Hospital from June 2020 to June 2023 were selected as the observation group,and another 105 healthy volunteers without schizophrenia who underwent physical examination during the same period were selected as the control group according to the 1:1 matching principle.The plasma levels of miR-155 and miR-195 in the two groups were compared,and the behavioral assessment of executive dysfunction syndrome(BADS)scores and plasma levels of miR-155 and miR-195 were compared between the patients with or without executive dysfunction in the observation group.The diagnostic value of plasma levels of miR-155 and miR-195 for executive dysfunction was analyzed using receiver operating characteristic(ROC)curves,and the correlation between plasma levels of miR-155 and miR-195 and BADS scores was analyzed using Pearson's method.The impact of the above indicators on the occurrence of executive dysfunction in first-episode schizophrenia was analyzed through interaction analysis.Results The plasma levels of miR-155 and miR-195 in the observation group were 1.88±0.54 and 1.93±0.37,respectively,which were significantly higher than 0.98±0.30 and 1.06±0.15 in the control group(P<0.05).The scores of card test,action planning test,key search test,time judgment,zoo route,revised six element test,and BADS total score in patients with executive dysfunction were(2.02±0.25)points,(1.21±0.14)points,(1.13±0.10)points,(1.54±0.19)points,(0.86±0.22)points,(1.40±0.28)points,and(8.16±0.41)points,respectively,which were significantly lower than(3.55±0.14)points,(3.36±0.18)points,(3.43±0.15)points,(3.48±0.16)points,(3.29±0.20)points,(3.40±0.12)points,and(20.51±1.03)points in patients without executive dysfunction,and the plasma levels of miR-155 and miR-195 in the observation group were 2.07±0.31 and 2.15±0.33,respectively,which were significantly higher than 1.78±0.24 and 1.81±0.20 in patients without executive dysfunction(P<0.05).The results of Pearson's analysis showed that plasma miR-155 and miR-195 were negatively correlated with card testing,action planning testing,key search testing,time judgment,zoo route,revised six element test score,and BADS total score(P<0.05).The ROC analysis showed that the AUC of plasma miR-155 combined with miR-195 to diagnose executive dysfunction in first-episode schizophrenic patients was 0.911(95%CI:0.839-0.957),with a Youden index of 0.742,sensitivity of 91.89%,and specificity of 82.35%.The interaction analysis showed that positive expression of miR-155 and miR-195 had a positive interaction on executive dysfunction in first-episode schizophrenic patients(32.178<7.572×11.357,which was a sub-multiplication model),P<0.05.Conclusion Plasma miR-155 and miR-195 levels are closely related to the occurrence of executive dysfunction in first-episode schizophrenia,and positive levels of the two indicators have a positive interaction in the occurrence of executive dysfunction.Combined detection has certain diagnostic value for executive dysfunction.
作者
白倩
孙臻
孙燕
张航雷
BAI Qian;SUN Zhen;SUN Yan;ZHANG Hang-lei(Department of General Psychiatry,Shangqiu Second People's Hospital,Shangqiu 476000,Henan,CHINA;Sleep Medicine Center,the Second Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,Henan,CHINA)
出处
《海南医学》
CAS
2024年第11期1585-1590,共6页
Hainan Medical Journal
基金
2022年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20225055)。
作者简介
第一作者:白倩(1986-),女,副主任医师,主要研究方向为早期精神分裂症的识别与诊断;通讯作者:张航雷(1987-),男,硕士,副主任医师,主要研究方向为应激与心理行为障碍的相关研究,E-mail:2458437535@qq.com。
