老年阿尔茨海默病患者尿液中神经丝蛋白含量的研究  

The Study of AD7c-NTP Level in Urine of Elders with Alzheimer's Disease

作　　者：李亚健[1] 潘逸茹[2] 王亚岚[2] 林文筠 周益萍[1] 孙晓静[1] 魏文石[1] 

机构地区：[1]复旦大学附属华东医院神经内科,200040 [2]复旦大学附属华东医院检验科,200040 [3]复旦大学附属华东医院老年科,200040

出　　处：《中国临床神经科学》2014年第2期198-202,共5页Chinese Journal of Clinical Neurosciences

基　　金：上海市科委医学引导项目(编号:124119a8802)

摘　　要：目的 探讨尿液中阿尔茨海默病（AD）相关神经丝蛋白（AD7c-NTP）含量在老年AD诊断中的意义.方法 选择老年AD患者67例（AD组）和认知功能正常老年人（对照组）85名,应用简易精神状态检查（MMSE）量表、日常生活活动（ADL）量表和临床痴呆评定（CDR）量表进行精神状态评价,采用酶联免疫吸附测定（ELISA）法检测尿AD7c-NTP含量.结果 尿AD7c-NTP含量AD组为（2.34±1.59） μg·L-1,对照组为（1.04±0.39） μg·L-1,两组间差异有统计学意义（t=-6.59,P=0.000）.经相关性分析表明AD7c-NTP水平与MMSE、FT4值呈负相关（R=-0.689,P=0.000; R=-0.211,P=0.009）;与ADL、CDR值呈正相关（R=0.267,P=0.001;R=0.52,P=0.001）.根据ROC曲线,确定1.492 μg·L-1为界定值,其对应的敏感度和特异度分别为82.1％和95.3％,ROC曲线下面积为0.924,95％CI：0.88～0.97.结论 尿AD7c-NTP含量检测可作为老年AD患者辅助诊断的生物学指标.Aim To explore the value of urine AD7c-NTP assay in the elder Alzheimer＇ s disease patients （AD）. Methods The level of the urine Alzheimer-associated neuronal thread protein （AD7c-NTP） was determined using enzyme-linked immunosorbent assay （ELISA） in two groups, one was AD group of sixty- seven patients and the other was the control group of eighty-five normal persons. Results The average level of the urine AD7c-NTP in AD group was （2.34 ± 1.59） μg·L-1, and the average level in control group was （1.04 ± 0.39） μg·L-1. There were differences between this two groups （t=-6.59, P=0.000）. The level of ADTc-NTP was negatively related with Mini-Mental State Examination （MMSE） scores and the value of FT4 （R=-0.689, P=-0.000; R=0.211, P=-0.009）, while it was positively related with Activities of Daily Living （ADL） scores and Clinical Dementia Rating （CDR） scores （R=0.267, P=0.001; R=0.52, P=0.001）. Using receiver operating characteristic （ROC） curve, the optimal cutoff point of AD7c-NTP in urine for diagnosis of AD was 1.492μg·L-1, with 82.1% sensitivity and 95.3% specificity, the area under the curve was 0.924 （95%CI： 0.88-0.97）. Conclusion The level of AD7c-NTP in urine may be a good indicator helpful to AD diagnosis.

关 键 词：阿尔茨海默病 简易精神状态检查量表 日常生活活动量表 临床痴呆评定量表 阿尔茨海默病相关神经丝蛋白 尿液 

分 类 号：R749.1[医药卫生—神经病学与精神病学]