Abstract: Objective　To observe the serum levels of micronucleotide-26b (miRNA-26b), homocysteine (Hcy), and β amyloid precursor protein (β-APP) in patients with Alzheimer's disease (AD), and to analyzed their correlations with the severity of the disease and clinical significance. Methods　Sixty-five patients with AD treated in Liaocheng Third People's Hospital from August 2019 to March 2022 were selected as an observation group, including 28 males and 37 females, and they were (75.61 ± 5.13) years old. According to the score of Global Deteriorate Scale (GDS), the patients were divided into a mild AD group (27 cases), a moderate AD group (21 cases), and a severe AD group (17 cases). Sixty healthy examinees in the same period were selected as a control group, including 31 males and 29 females, and they were (74.82 ± 5.27) years old. The serum levels of miRNA-26b, Hcy, and β-APP were detected. The data were analyzed by SPSS 23.0. The data were compared between 3 or more than 3 groups by one-way ANOVA, and between 2 groups by LSD-t test. The levels of serum indicators in the observation group, the control group, and the AD patients with different disease degrees were compared. The correlation between them and the severity of AD was analyzed. Results　The serum levels of miRNA-26b, Hcy, and β-APP were (0.51±0.16), (21.45±6.29) μmol/L, and (92.57±28.60) ng/L in the observation group, and were (1.07±0.28), (15.07±4.38) μmol/L, and (51.54±9.27) ng/L in the control group, with statistical differences (all P<0.05). The serum levels of miRNA-26b, Hcy, and β-APP were (0.36±0.15), (26.27±5.62) μmol/L, and (102.72±26.47) ng/L in the severe AD group, were (0.58±0.14), (17.83±4.39) μmol/L, and (81.21±22.68) ng/L in the mild AD group, and were (0.54±0.15), (22.20±4.54) μmol/L, and (98.96±25.89) ng/L in the moderate AD group, with statistical differences between the severe AD group on one hand and the mild AD group and the moderate AD group on the other hand (all P<0.05). The scores of GDS, Mini-Mental State Examination (MMSE), and Activity of Daily Living Scale (ADL) were (6.22±0.43), (6.76±1.31), and (13.58±1.68) in the severe AD group, were (2.51±0.39), (23.47±3.19), and (24.10±1.37) in the mild AD group, and were (4.36±0.38), (16.24±2.55), and (18.93±1.59) in the moderate AD group, with statistical differences between the severe AD group on one hand and the mild AD group and the moderate AD group on the other hand (all P<0.05). Pearson correlation analysis showed that serum miRNA-26b was negatively correlated with GDS score, and positively with MMSE and ADL scores (r₁=-0.613, r₂=0.702, r₃=0.536, all P<0.05); serum Hcy was positively correlated with GDS score, and negatively with MMSE and ADL scores (r₁=0.608, r₂=-0.549, r₃=-0.625, all P<0.05); serum β-APP was positively correlated with GDS score, and negatively with MMSE and ADL scores (r₁=0.720, r₂=-0.568, r₃=-0.489, all P<0.05). Conclusions　In AD patients, the serum level of miRNA-26b decreases, and the levels of Hcy and β-APP increase. The severity of AD relates to the serum levels of miRNA-26b, Hcy, and β-APP; they participate in the progress of AD.

Key words: Alzheimer's disease, Micronucleotide-26b, Homocysteine, β Amyloid precursor protein, Correlation

摘要： 目的　观察阿尔茨海默病（AD）患者血清微小核苷酸-26b（miRNA-26b）、同型半胱氨酸（Hcy）、β淀粉样前体蛋白（β-APP）水平变化，分析其与病情程度的相关性及临床意义。方法　选取2019年8月至2022年3月聊城市第三人民医院收治的65例AD患者为观察组，男28例，女37例，年龄（75.61±5.13）岁；根据总体衰退量表（GDS）评分为轻度AD组（27例）、中度AD组（21例）、重度AD组（17例），另选取同期60例健康体检者为对照组，男31例，女29例，年龄（74.82±5.27）岁；均检测血清miRNA-26b、Hcy、β-APP水平，采用SPSS 23.0对数据进行分析，多组间比较以单因素方差进行分析，两两比较采用LSD-t检验，对比观察组与对照组、不同病情程度AD患者血清各指标水平，分析其与AD患者病情程度的相关性。结果　观察组患者血清miRNA-26b为（0.51±0.16），低于对照组的（1.07±0.28），观察组患者血清Hcy为（21.45±6.29）μmol/L、β-APP（92.57±28.60）ng/L，均高于对照组［（15.07±4.38）μmol/L、（51.54±9.27）ng/L］，两组比较，差异均有统计学意义（均P<0.05）；重度AD组血清miRNA-26b为（0.36±0.15），较轻度AD组（0.58±0.14）、中度AD组（0.54±0.15）低，血清Hcy为（26.27±5.62）μmol/L、β-APP为（102.72±26.47）ng/L，较轻度AD组［（17.83±4.39）μmol/L、（81.21±22.68）ng/L］、中度AD组［（22.20±4.54）μmol/L、（98.96±25.89）ng/L］高（均P<0.05）；重度AD组GDS评分为（6.22±0.43）分，较轻度AD组［（2.51±0.39）分］、中度AD组［（4.36±0.38）分］高，简易智能精神状态量表（MMSE）评分为（6.76±1.31）分、日常生活能力量表（ADL）评分为（13.58±1.68）分，较轻度AD组［（23.47±3.19）分、（24.10±1.37）分］、中度AD组［（16.24±2.55）分、（18.93±1.59）分］低（均P<0.05）；Pearson相关性分析显示，血清miRNA-26b与GDS评分呈负相关，与MMSE、ADL评分呈正相关（r₁=-0.613，r₂=0.702，r₃=0.536，均P<0.05）；血清Hcy与GDS评分呈正相关，与MMSE、ADL评分呈负相关（r₁=0.608，r₂=-0.549，r₃=-0.625，均P<0.05）；血清β-APP与GDS评分呈正相关，与MMSE、ADL评分呈负相关（r₁=0.720，r₂=-0.568，r₃=-0.489，均P<0.05）。结论　AD患者血清miRNA-26b水平降低，Hcy、β-APP水平升高，其病情严重程度与血清miRNA-26b、Hcy、β-APP水平变化具有一定相关性，参与AD病情进展。

关键词: 阿尔茨海默病, 微小核苷酸-26b, 同型半胱氨酸, β淀粉样前体蛋白, 相关性