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南京医科大学学报（自然科学版）                                  第42卷第3期
               ·340 ·                     Journal of Nanjing Medical University（Natural Sciences）   2022年3月


             ·临床研究·

              血浆外泌体 miR⁃409⁃3p 的异常表达与冠状动脉搭桥术围术期

              神经认知障碍的相关性分析



              司林杰 ，李娜娜 ，陈艺南 ，胡柳青             2*
                     1
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                             2
               南京医科大学第一附属医院心脏大血管外科，麻醉与围术期医学科，江苏                          南京   210029
              1                                   2

             ［摘    要］ 目的：分析血浆外泌体miR⁃409⁃3p与冠状动脉搭桥术围术期神经认知障碍（perioperative neurocognitive disorders，
              PND）的相关性。方法：共纳入76 例冠状动脉搭桥术患者，于术前1 d和术后7 d进行神经心理测试评估，并根据评估结果将患
              者分为PND组（n=24）和非PND组（n=52）。提取所有患者血浆外泌体，分别采用透射电镜、粒径分析、Western blot对其进行鉴
              定。采用qRT⁃PCR检测外泌体miR⁃409⁃3p的表达水平。Logistic 回归分析PND发生的危险因素。结果：两组在年龄、手术时
              间及教育年限方面差异有统计学意义。血浆外泌体miR⁃409⁃3p在PND组中的表达高于非PND组。年龄、手术时间及外泌体
              miR⁃409⁃3p为PND 发生的独立危险因素。结论：高表达的血浆外泌体miR⁃409⁃3p可作为冠状动脉搭桥术PND的新型分子标
              志物。
             ［关键词］ 围术期神经认知障碍；外泌体；小RNA；冠状动脉搭桥术
             ［中图分类号］ R654.2                    ［文献标志码］ A                       ［文章编号］ 1007⁃4368（2022）03⁃340⁃06
              doi：10.7655/NYDXBNS20220305



              Correlation analysis of plasma exosomal miR ⁃ 409 ⁃ 3p in perioperative neurocognitive
              disorders of patients undergoing coronary artery bypass graft surgery

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              SI Linjie ，LI Nana ，CHEN Yinan ，HU Liuqing 2*
               Department of Cardiovascular Surgery，Department of Anesthesiology，the First Affiliated Hospital of Nanjing
              1                                  2
              Medical University，Nanjing 210029, China
             ［Abstract］ Objective：This study aims to analyze the correlation between plasma exosomal miR ⁃ 409 ⁃ 3p and perioperative
              neurocognitive disorders（PND）after coronary artery bypass grafting. Methods：A total of 76 patients undergoing coronary artery
              bypass graft surgery were enrolled in this study. Neuropsychological test assessments were performed 1 day before and 7 days after
              surgery，and the patients were divided into PND group（n=24）and non⁃PND group（n=52）according to the evaluation results. The
              plasma exosomes of all patients were extracted，and were identified by transmission electron microscopy，particle size analysis，and
              Western blot. The qRT⁃PCR was used to detect the expression level of exosomal miR⁃409⁃3p. Logistic regression analysis was used to
              evaluate the risk factors for PND. Results：There were statistical differences between the two groups in age，operation time and
              education years. The expression of plasma exosomal miR⁃409⁃3p in PND patients was higher than that in non⁃PND patients. Age，
              operation time，and plasma exosomal miR⁃409⁃3p were independent risk factors for PND. Conclusion：The highly expressed plasma
              exosomal miR⁃409⁃3p can be used as a new molecular marker for PND in patients undergoing coronary artery bypass graft surgery.
             ［Key words］ perioperative neurocognitive disorder；exosome；micoRNA；coronary artery bypass graft
                                                                         ［J Nanjing Med Univ，2022，42（03）：340⁃344，351］





                                                                     围术期神经认知障碍（perioperative neurocogni⁃
             ［基金项目］ 国家自然科学基金青年项目（82101278，                      tive disorders，PND）是手术后中枢神经系统的并发
              81801061）                                         症，表现为精神障碍、焦虑、性格改变和记忆障碍。
              ∗                                                 许多风险因素与 PND 相关，包括年龄、术前认知和
              通信作者（Corresponding author），E⁃mail：hu_liuqing@126.com
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