尿阿尔茨海默病相关神经丝蛋白与外周血CD45RA+T细胞亚群联合检测早期诊断阿尔茨海默病  

Combined detection of urinary AD7c-NTP and peripheral blood CD45RA^+ T lymphocyte subsets in early diagnosis of Alzheimer disease

作　　者：郑磊[1] 郑文选[2] 袁栋才[3] 张金荣[1] 魏琰[3] 

机构地区：[1]哈励逊国际和平医院中心实验室,河北衡水053000 [2]哈励逊国际和平医院口腔科,河北衡水053000 [3]哈励逊国际和平医院神经内科,河北衡水053000

出　　处：《临床荟萃》2015年第2期196-199,共4页Clinical Focus

基　　金：河北省医学科学课题研究计划(20130345);哈励逊国际和平医院研究生课题(201202)

摘　　要：目的探讨尿阿尔茨海默病相关神经丝蛋白(Alzheimer disease related neural thread protein,AD7cNTP)与外周血淋巴细胞CD45RA+T亚型联合检测在阿尔茨海默病(AD)早期诊断中的价值。方法根据Peterson制订的轻度认知功能障碍(MCI)诊断标准和美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)有关AD的诊断标准,选取AD患者32例(AD组),MCI患者30例(MCI组),另选60例健康者作为对照组。对比各组尿AD7c-NTP与CD45RA+T细胞亚群变化及诊断价值。结果 1CD45RA+T蛋白表达水平在AD组和MCI组显著低于对照组(P<0.01);2CD45RA+T在AD组和MCI组中的相对表达水平较对照组显著降低(P<0.01),AD组与MCI组间差异无统计学意义(P>0.05);3尿AD7c-NTP在AD组和MCI组中的含量较对照组显著升高(P<0.01),AD组与MCI组间差异无统计学意义(P>0.05);4CD45RA+T与AD7c-NTP联合诊断具有较好的敏感度、特异度、阳性预测值、阴性预测值。结论 AD7c-NTP与CD45RA+T联合检测是诊断AD早期病变的较好指标,提升二者单独应用时的预测价值,为AD早期诊断及疗效监测提供参考。Objective To investigate the significance of the combined detection of urinary Alzheimer disease related neural thread protein（AD7c-NTP）and peripheral blood CD45RA^＋T lymphocyte subsets in early diagnosis of Alzheimer disease.Methods According to the clinical criteria for the diagnosis of mild cognitive impairment（Peterson2004b）and American Diagnostic criteria and Statistical Manual of mental disorders Ⅳ for Alzheimer disease,62 patients were enrolled in this study and then grouped into AD group（n =32）and mild cognitive impairment group（MCI group,n=30）.Sixty healthy individuals were recruited as control group.Then,the urinary AD7c-NTP and peripheral blood CD45RA^＋T lymphocyte subsets were determined and compared.Results The expression of CD45 RA in AD and MCI groups were significantly less than that in control group（P〈0.01）and the percentages of CD45RA^＋CD4＋T cells in AD and MCI groups also decreased significantly as compared with that of control group（P〈0.01）,but no significant differences were found between AD and MCI group（P〉0.05）.The content of urinary AD7 cNTP in AD and MCI groups were markedly higher than that of control group（P〈0.01）,while there was no significant difference between AD and MCI group（P〉0.05）.The combined detection of urinary AD7c-NTP and peripheral blood CD45RA^＋T lymphocyte subsets had better diagnostic sensitivity,specificity,positive predictive value and negative predictive value than either detection alone.Conclusion The combined detection of urinary AD7c-NTP and peripheral blood CD45RA^＋T lymphocyte subsets is a reliable method for early diagnosis of Alzheimer disease,since the combined method can enhance the predictive value as compared with the detection alone.It suggests that the combined detection may provide a theoretical basis for early diagnosis and monitor of AD.

关 键 词：阿尔茨海默病 神经微丝蛋白质类 抗原 CD45 T淋巴细胞亚群 

分 类 号：R745.7[医药卫生—神经病学与精神病学]