血浆β-淀粉样蛋白对MCI及AD患者检测的诊断价值分析  

Diagnostic value of plasma β-amyloid protein in patients with MCI and AD

作　　者：曲畅达 张丽梅[2] 潘玉君[1] 姚海乾[2] 姜世香[3] Qu Changda;Zhang Limei;Pan Yujun;Yao Haiqian;Jiang Shixiang(Department of Neurology,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Department of Neurology,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Heilongjiang Academy of Medical Sciences,Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学第一附属医院神经内科,150001 [2]哈尔滨医科大学第二附属医院神经内科,150086 [3]哈尔滨医科大学黑龙江省医学科学院,哈尔滨150081

出　　处：《国际免疫学杂志》2021年第4期370-376,共7页International Journal of Immunology

基　　金：国家自然科学基金(81973068,71974049,81871003);黑龙江省博士后科研启动基金(LBH-Q19129)。

摘　　要：目的探讨血浆β-淀粉样蛋白(amyloidβ-protein,Aβ)在阿尔茨海默病(Alzheimer’s disease,AD)及轻度认知功能障碍(mild cognitive impairment,MCI)中的识别诊断作用,为寻求MCI识别诊断和转归预测的生物标志物提供依据。方法选取2018年5月至2019年1月期间哈尔滨附属第二医院神经内科门诊及住院老年人46名作为病例组,另外选取同期认知功能正常的健康老年人30人作为对照组。根据认知评估量表将病例组分为AD组和MCI组,每组各23人。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)法检测血浆中Aβ1-40及Aβ1-42蛋白浓度。应用受试者工作特征曲线(receiver operating characteristic curve,ROC)判断Aβ生化指标对鉴别诊断MCI及AD患者的灵敏度和特异性。结果正常对照组、MCI组及AD组患者血浆Aβ1-40表达水平差异具有统计学意义[(405.33±113.88)pg/mL比(523.05±173.94)pg/mL比(423.59±74.23)pg/mL,F=6.206,P<0.05]。与对照组和AD组相比,MCI组Aβ1-40表达水平明显升高(P值分别为0.001和0.009)。AD组Aβ1-40表达较正常对照组升高,但组间差异不具有统计学意义(P>0.05)。三组间血浆Aβ1-42表达水平及Aβ1-40/Aβ1-42比值差异均不具有统计学意义(P>0.05)。多元线性回归分析结果显示,年龄、教育水平、性别对Aβ1-40均无显著影响(P>0.05)。Aβ1-40诊断MCI的ROC曲线下面积为0.703(P=0.005),Aβ1-40对MCI具有一定的诊断意义;当Aβ1-40浓度临界值为415.06时,鉴别诊断MCI的灵敏性和特异性分别为73.9%和43.4%。结论Aβ1-40对于识别诊断MCI的敏感性较好,而血浆Aβ1-42及Aβ40/Aβ1-42尚不能作为识别诊断MCI及AD的生物学指标。Objective To explore the role of plasma amyloid beta-protein(Aβ)in the identification and diagnosis of Alzheimer's disease(AD)mild cognitive impairment(MCI)and for seeking biomarkers for MCI identification,diagnosis and prognosis prediction.Methods Total of 46 elderly outpatients and inpatients in the Department of Neurology of the Second Affiliated Hospital of Harbin Medical University were selected as case group from May 2018 to January 2019,and 30 healthy elderly with normal cognition were also selected as control group at the same time.According to cognitive assessment scale,the case group was divided into AD group and MCI group with 23 patients in each group.Plasma Aβ1-40 and Aβ1-42 protein concentration were detected by enzyme linked immunosorbent assay(ELISA).Receiver operating characteristic curve(ROC)was used to judge the sensitivity and specificity of Aβbiochemical indexes in the differential diagnosis of MCI and AD.Results The significant difference has been found in the levels of plasma Aβ1-40 among the normal control group,MCI group and AD group[(405.33±113.88)pg/mL vs(523.05±173.94)pg/mL vs(423.59±74.23)pg/mL,F=6.206,P<0.05].The expression level of Aβ1-40 in MCI group was significantly higher than the control group and AD group(P values were 0.001 and 0.009 respectively).The expression level of Aβ1-40 in AD group was aslo higher than that in the normal control group,but the difference was not statistically significant(P>0.05).There was no significant difference in plasma Aβ1-42 and Aβ1-40/Aβ1-42 among the three groups(P>0.05).The results of multiple linear regression analysis showed that age,education level and gender had no significant effect on Aβ1-40(P>0.05).The area under the ROC curve for Aβ1-40 diagnosis of MCI was 0.703(P=0.005),indicated that Aβ1-40 has certain diagnostic significance for the identification and diagnosis of MCI.When the critical value of Aβ1-40 concentration was 415.06,the sensitivity and specificity of differential diagnosis MCI were 73.9%and 43.4%respectiv

关 键 词：轻度认知功能障碍 阿尔茨海默症 Β-淀粉样蛋白 

分 类 号：R749.16[医药卫生—神经病学与精神病学]