尿液β淀粉样蛋白寡聚体检测在阿尔茨海默病和轻度认知损害中临床意义的初步探索  

Preliminary Exploration of Clinical Significance of Measuring Urinary Beta Amyloid Oligomer in Patient with Alzheimer’s Disease and Mild Cognitive Impairment

作　　者：陈小童 陈秋丹 陈淑英 林勇 CHEN Xiao-tong;CHEN Qiu-dan;CHEN Shu-ying;LIN Yong(Department of Laboratory Medicine,Huashan Hospital of Fudan University,Shanghai 200040,China;Department of Laboratory Medicine,Jing'an District Centre Hospital of Shanghai,Jing’an Branch Affiliated to Huashan Hospital,Fudan University Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院检验医学科,上海市200040 [2]上海市静安区中心医院(复旦大学附属华山医院静安分院)检验医学科,上海市200040

出　　处：《中国临床神经科学》2021年第3期296-302,共7页Chinese Journal of Clinical Neurosciences

基　　金：国家重点研发计划项目(编号:2018YFC2000204)。

摘　　要：目的探索阿尔茨海默病(AD)患者尿液β淀粉样蛋白(Aβ)寡聚体水平及其临床意义。方法收集60例病例组研究对象:包括轻度认知损害(MCI)组28例、AD组15例、主观认知下降(SCD)组17例;另选择上海市宝山区友谊街道社区认知正常健康者(对照组)19例。收集患者临床信息以及尿液,利用脑脊液Aβ寡聚体检测ELISA试剂盒检测研究对象尿液Aβ寡聚体水平,比较组间差异;评价尿液Aβ寡聚体水平与MMSE量表、MoCA-B量表认知功能的相关性。由于MMSE量表相较于MoCA-B量表对MCI的灵敏度不高,因此将研究对象进行重新分组,分为:所有受试者组(79例)、对照+SCD+MCI组(64例)和AD组(15例)。结果SCD组尿液Aβ寡聚体水平(0.026±0.011)ng·mL^(-1),较对照组(0.024±0.009)ng·mL^(-1)、MCI组(0.020±0.015)ng·mL^(-1)和AD组(0.019±0.013)ng·mL^(-1)增高;对照组和SCD组Aβ寡聚体水平与MCI组比较,差异均有统计学意义(P=0.0350,P=0.0122)。相关分析结果显示尿液Aβ寡聚体水平与MoCA-B量表评分具有显著相关性,MCI组(r=0.4413,P=0.0187),SCD+MCI组(r=0.3819,P=0.0096)。相较于所有受试者组和对照+SCD+MCI组,AD组Aβ寡聚体水平与MMSE量表评分的相关系数较高(r=0.3414,P=0.2130)。结论利用脑脊液Aβ寡聚体检测试剂盒检测尿液Aβ寡聚体有效,尿液Aβ寡聚体作为一种新型的生物标志物有望应用于AD的早期筛查。Aim To explore the clinical significance of measuring urinary β-amyloid(Aβ)oligomer in patients with Alzheimer’s disease(AD).Methods A total of 60 patients were collected,including 17 with subjective cognitive decline(SCD),28 with mild cognitive impairment(MCI)and 15 with AD.Nineteen cognitive normal from Baoshan District Youyi Community of Shanghai were enrolled as the control group.The clinical information and urine were collected,and the level of urinary Aβ oligomer was measured by ELISA kit.The differences of the level of urinary Aβ oligomer between the four groups were compared and the correlation between urinary Aβ oligomer and cognition were analysed.Results The level of urinary Aβ oligomer in SCD group(0.026±0.011)ng/ml was higher than that in the control group(0.024±0.009)ng·mL^(-1),MCI group(0.020±0.015)ng·mL^(-1) and AD group(0.019±0.013)ng·mL^(-1).Furthermore,there was significant difference between SCD group and MCI group in the level of urinary Aβ oligomer.The results of correlation analysis showed that the level of urinary Aβ oligomer was correlated with the score of Mo CA-B,and the correlation coefficient was 0.4413 for MCI group and 0.3819 for SCD plus MCI group.Conclusion Applying cerebrospinal fluid Aβ oligomer detection kit to detecting urinary Aβ oligomer is effective,and urinary Aβ oligomer as a new biomarker may be potential to become an early screening biomarker for AD.

关 键 词：阿尔茨海默病 轻度认知损害 尿液 Β淀粉样蛋白 寡聚体 主观认知下降 

分 类 号：R446.12[医药卫生—诊断学]