神经病理性疼痛患者血清miR-15a水平及意义分析

doi:10.3877/cma.j.issn.2095-123X.2023.05.006

目的

检测血清微小核糖核酸-15a（miR-15a）在神经病理性疼痛（NP）患者中的表达水平，并分析临床意义。

方法

选取天津医科大学第二医院神经内科自2019年10月至2022年1月收治的115例NP患者作为研究组，另选取同期在本院体检的115例无疼痛且身体健康者作为对照组。采用视觉模拟评分法（VAS）评估研究组患者的疼痛强度；采用焦虑自评量表（SAS）、抑郁自评量表（SDS）评估研究组和对照组的焦虑、抑郁情况；采用实时荧光定量PCR检测研究组和对照组的血清miR-15a表达水平。比较2组受试者的SAS、SDS评分及血清miR-15a表达水平；比较研究组中不同病因患者VAS评分和血清miR-15a表达水平，统计焦虑、抑郁发生情况，并比较有无焦虑、抑郁患者的血清miR-15a表达水平。采用Pearson法分析研究组患者血清miR-15a表达水平与疼痛、焦虑、抑郁程度的关系。

结果

研究组患者焦虑、抑郁的发生率分别为32.17%和51.30%。研究组患者SAS、SDS评分和血清miR-15a表达水平均高于对照组，差异有统计学意义（P<0.05）。研究组中不同病因患者的VAS评分、血清miR-15a表达水平比较，差异有统计学意义（P<0.05）；焦虑、抑郁患者血清miR-15a表达水平均高于无焦虑、无抑郁患者，差异有统计学意义（P<0.05）。血清miR-15a表达水平与VAS、SAS、SDS评分均呈正相关（P<0.05）。

结论

NP患者不仅存在高强度的疼痛，还易并发焦虑和抑郁，其血清miR-15a呈高表达，且血清miR-15a表达水平与疼痛、焦虑、抑郁程度密切相关。

关键词: 神经病理性疼痛, 微小核糖核酸-15a, 焦虑, 抑郁

Objective

To detect the expression level of serum miRNA-15a (miR-15a) in patients with neuropathic pain (NP) and analyze its clinical significancen.

Methods

One hundred and fifteen patients with NP admitted to the Neurology Department of Second Hospital of Tianjin Medical University from October 2019 to January 2022 were selected as the study group, and 115 patients without pain and in good health who underwent physical examination during the same period were selected as the control group. Visual analogue scale (VAS) was used to evaluate the pain intensity of the study group, and self rating anxiety scale (SAS) and self rating depression scale (SDS) were used to evaluate the anxiety and depression of patients in the study group and the control group, and real-time fluorescence quantitative polymerase chain reaction was used to quantitatively detect the expression level of serum miR-15a in the study group and the control group. SAS, SDS scores and serum miR-15a expression levels were compared between the study group and the control group. The VAS scores and serum miR-15a expression levels of patients with different etiologies in the study group were compared. The occurrence of anxiety and depression in the study group was counted, and the expression levels of serum miR-15a were compared between patients with anxiety and depression and patients without anxiety and depression in the study group. Pearson method was used to analyze the relationship between the serum miR-15a expression level and pain, anxiety and depression scores in the study group.

Results

The incidence of anxiety and depression in the study group were 32.17% and 51.30%, respectively. The SAS, SDS scores and serum miR-15a expression levels in the study group were higher than those in the control group (P<0.05). There were statistically significant difference in VAS scores and serum miR-15a expression levels among patients with different etiologies in the study group (P<0.05). The expression levels of serum miR-15a in patients with anxiety and depression in the study group were higher than those in patients without anxiety and depression (P<0.05). The expression level of serum miR-15a in the study group was positively correlated with VAS, SAS and SDS scores (P<0.05).

Conclusion

NP patients not only have high-intensity pain, but also are prone to be complicated with anxiety and depression. Serum miR-15a is highly expressed in NP patients, and the expression level of serum miR-15a is closely related to the degree of pain, anxiety and depression.

Key words: Neuropathic pain, MicroRNA-15a, Anxiety, Depression

表1 2组受试者SAS、SDS评分及血清miR-15a表达水平比较（Mean±SD）

Tab.1 Comparison of SAS scores, SDS scores, and serum miR-15a expression levels between two groups (Mean±SD)

组别	例数	SAS（分）	SDS（分）	miR-15a
研究组	115	46.20±7.89	52.42±14.27	4.76±0.54
对照组	115	32.58±7.64	35.09±8.77	1.00
t值		13.299	12.376	74.669
P值		<0.001	<0.001	<0.001

表1 2组受试者SAS、SDS评分及血清miR-15a表达水平比较（Mean±SD）

Tab.1 Comparison of SAS scores, SDS scores, and serum miR-15a expression levels between two groups (Mean±SD)

组别	例数	SAS（分）	SDS（分）	miR-15a
研究组	115	46.20±7.89	52.42±14.27	4.76±0.54
对照组	115	32.58±7.64	35.09±8.77	1.00
t值		13.299	12.376	74.669
P值		<0.001	<0.001	<0.001

表2 研究组不同病因患者VAS评分、血清miR-15a表达水平比较（Mean±SD）

Tab.2 Comparison SAS scores and serum miR-15a expression levels in patients with different etiologies in the study group (Mean±SD)

病因	例数	VAS（分）	miR-15a
带状疱疹神经痛	59	7.86±0.94	4.96±0.42
三叉神经痛	28	6.38±1.04^a	4.65±0.54^a
坐骨神经痛	10	5.24±0.69^ab	4.16±0.57^ab
脑卒中后神经痛	8	6.40±1.14^ac	4.73±0.52^c
糖尿病性周围神经病变	6	4.50±1.75^abd	4.36±0.74^a
多发性硬化性疼痛	2	5.40±0.42^ad	4.63±0.71
脊髓损伤性疼痛	2	6.80±0.42^ce	4.69±0.47
F值		21.552	4.926
P值		<0.001	<0.001

表2 研究组不同病因患者VAS评分、血清miR-15a表达水平比较（Mean±SD）

Tab.2 Comparison SAS scores and serum miR-15a expression levels in patients with different etiologies in the study group (Mean±SD)

病因	例数	VAS（分）	miR-15a
带状疱疹神经痛	59	7.86±0.94	4.96±0.42
三叉神经痛	28	6.38±1.04^a	4.65±0.54^a
坐骨神经痛	10	5.24±0.69^ab	4.16±0.57^ab
脑卒中后神经痛	8	6.40±1.14^ac	4.73±0.52^c
糖尿病性周围神经病变	6	4.50±1.75^abd	4.36±0.74^a
多发性硬化性疼痛	2	5.40±0.42^ad	4.63±0.71
脊髓损伤性疼痛	2	6.80±0.42^ce	4.69±0.47
F值		21.552	4.926
P值		<0.001	<0.001

图1 研究组血清miR-15a表达水平与VAS、SAS、SDS评分的相关性分析A：血清miR-15a表达水平与VAS评分的相关性；B：血清miR-15a表达水平与SAS评分的相关性；C：血清miR-15a表达水平与SDS评分的相关性；VAS：视觉模拟评分；SAS：焦虑自评量表；SDS：抑郁自评量表

Fig.1 Correlation analysis between serum miR-15a expression level and the scores of VAS, SAS and SDS in the study group

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Analysis of serum miR-15a level and significance in patients with neuropathic pain

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Analysis of serum miR-15a level and significance in patients with neuropathic pain