目的：研究年龄相关性黄斑变性(ARMD)患者血清miR-23a和miR-34a的表达水平及其与ARMD发生发展的关系。

方法：选取2015-05/2018-02在我院诊治的ARMD患者102例作为病例组，同期体检健康者70例作为对照组，采用RT-PCR检测两组受检者血清miR-23a、miR-34a相对表达量，采用酶联免疫吸附法(ELISA)检测血清肿瘤坏死因子α(TNF-α)和核因子κB(NF-κB)水平，分析ARMD患者血清miR-23a、miR-34a表达水平与TNF-α、NF-κB的关系及其对ARMD的诊断价值。

结果：病例组患者血清miR-23a和miR-34a相对表达量均显著高于对照组(P<0.01)； 病例组晚期患者血清miR-23a和miR-34a相对表达量均显著高于中期和早期患者(P<0.01)，中期患者血清miR-23a和miR-34a相对表达量均显著高于早期患者(P<0.01)。病例组患者血清TNF-α和NF-κB水平均显著高于对照组(P<0.01)。病例组患者血清miR-23a与TNF-α、NF-κB均呈显著正相关(r=0.798、0.720，均P<0.01)，血清miR-34a与TNF-α、NF-κB均呈显著正相关(r=0.814、0.740，均P<0.01)。血清miR-23a、miR-34a诊断ARMD的ROC曲线下面积(AUC)分别为0.831、0.867。

结论：ARMD患者血清miR-23a和miR-34a表达上调，可能通过促进炎症和氧化应激反应参与ARMD发生及发展过程，检测血清miR-23a和miR-34a有助于ARMD的早期辅助诊断及预防治疗。

METHODS: Totally 102 patients with ARMD who were treated in our hospital from May 2015 to February 2018 were enrolled in the case group, and 70 healthy subjects in the same period were used as control group. The relative expression levels of miR-23a and miR-34a in serum were detected by RT-PCR, and the levels of serum tumor necrosis factor alpha(TNF-α)and nuclear factor kB(NF-kB)were detected by enzyme linked immunosorbent assay(ELISA). Analysis on the relationship of miR-23a, miR-34a expression levels with TNF-a, NF-kB in patients with ARMD and its diagnostic value for ARMD were taken.

RESULTS: The relative expression levels of serum miR-23a and miR-34a in the case group were significantly higher than those in the control group(P<0.01). The relative expression levels of serum miR-23a and miR-34a in the advanced group were significantly higher than those in the middle and early stage(P<0.01). The relative expression levels of serum miR-23a and miR-34a in the middle term patients were significantly higher than those in the early stage(P<0.01). The serum levels of TNF- α and NF-κB in the case group were significantly higher than those in the control group(P<0.01). There was a significant positive correlation between serum miR-23a and TNF-α and NF-kB in the case group(r=0.798, 0.720, both P<0.01), and serum miR-34a was significantly positively correlated with TNF-α and NF-kB(r=0.814, 0.740, both P<0.01). The area under the ROC curve(AUC)of serum miR-23a and miR-34a for diagnosis of ARMD was 0.831 and 0.867, respectively.

CONCLUSION: The expression of miR-23a and miR-34a in serum of ARMD patients is up-regulated, which may be involved in the development and progression of ARMD by promoting inflammation and oxidative stress. Detection of serum miR-23a and miR-34a may be helpful for early diagnosis and prevention of ARMD.