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目的:探讨老年帕金森病(Parkinson disease，PD)患者血清微小RNA-124(miR-124)、微小RNA-494(miR-494)表达水平及其临床意义。方法:选取2018年3月～2020年4月在郑州大学附属郑州中心医院住院治疗的90例PD患者(PD组)；同期选择在医院体检中心检查且与PD患者年龄、性别相匹配的100名非PD老年人作对照组。所有研究对象空腹12 h后取清晨静脉血4 ml，采用帕金森等级量表(unified Parkinson disease rating scale，UPDRS)对所有PD组患者从精神状态、行为和情感、生活质量、运动检查进行评分，利用帕金森病Hoehn-Yahr分级量表对PD患者进行分级；利用实时荧光定量PCR(qRT-PCR)技术检测血清miR-124和miR-494表达水平；作ROC曲线判断miR-124、miR-494对PD患者的诊断价值。结果:UPDRS评分≤60分的PD患者Hoehn-Yahr分级明显低于UPDRS>60分的患者[(2.47±0.43)分，(3.42±0.47)分]，差异有统计学意义(n t＝9.055，n P<0.001)，但血清miR-124、miR-494表达水平差异无统计学意义[miR-124：(0.72±0.14)，(0.70±0.12)；miR-494：(1.17±0.19)，(1.18±0.22)](n t＝0.633，0.230，n P＝0.529，0.819)；与对照组相比，PD组血清miR-124表达下调[(0.71±0.20)，(1.05±0.24)]，miR-494表达上调[(1.18±0.26)，(0.96±0.22)](n t＝10.542，6.315，均n P60 points((2.47±0.43) n vs (3.42±0.47))(n t=9.055, n P<0.001), and there was no significant difference in serum miR-124 and miR-494 expression levels((0.72±0.14)n vs (0.70±0.12), (1.17±0.19) n vs (1.18±0.22)) (n t=0.633, 0.230, n P=0.529, 0.819). Compared with that in control group, the expression of miR-124 in PD group was down-regulated ((0.71±0.20) n vs (1.05±0.24)), and the expression of miR-494 was up-regulated((1.18±0.26) n vs (0.96±0.22)) (n t=10.542, 6.315, n P<0.001). The results of ROC showed that the area under curve (AUC) of serum miR-124 and miR-494 in the diagnosis of PD were 0.847 and 0.760 respectively, the cutoff values were 0.901 and 1.126, respectively, the sensitivities were 86.67% and 61.11% respectively, and the specificities were 75.03% and 79.00% respectively. The AUC of the combined diagnosis of PD was 0.898, and the sensitivity and specificity were 85.56% and 85.00% respectively.n Conclusions:The expression of miR-124 is low in PD patients, while the expression of miR-494 is high, which suggests that the changes of the two miRNA levels may be related with the occurrence and development of PD.Both of them have a certain diagnostic value for PD, and the value of combined diagnosis is higher.