嗅觉功能联合尿液AD7c-NTP检测对阿尔茨海默病早期诊断价值的探讨  

The Value of Olfactory Function Combined with Urine AD7c-NTP Detection in Early DiagAnosis of Alzheimer's Disease

作　　者：王艳[1] 李攀[1] 张惠红[1] 胡静仪[1] 周玉颖[1] WANG Yan;LI Pan;ZHANG Hui-hong;HU Jing-yi;ZHOU Yu-ying(Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院,天津300350

出　　处：《阿尔茨海默病及相关病杂志》2021年第3期226-230,共5页Chinese Journal of Alzheimer's Disease and Related Disorders

基　　金：国家自然科学基金项目(编号:81801076);天津市自然科学基金项目(编号:18JCQNJC11400)。

摘　　要：目的:探讨联合嗅觉功能及尿液阿尔茨海默病相关神经丝蛋白(AD7c-NTP)检测对阿尔茨海默病的早期诊断价值。方法:选取30例早期阿尔茨海默病(AD)、30例遗忘型轻度认知障碍(aMCI)、和30例年龄性别相匹配的正常志愿者(NC)。采用简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表(MoCA)评价三组受试人群认知功能,采用T&T嗅觉仪评估嗅觉功能。应用酶联免疫吸附试验检测尿液AD7c-NTP水平。Spearman秩相关分析评价认知功能与嗅觉功能及尿液AD7c-NTP水平的相关性。结果:察觉阈值检测,早期AD组-2.00[-2.00,-1.60];aMCI组-2.00[-2.00,-1.80];正常组-2.00[-2.00,-2.00];三组比较Z=3.678,P=0.159。识别阈值检测,早期AD组4.20[1.80,6.00],aMCI组2.00[1.00,3.00],正常组1.60[-0.80,2.90],三组比较F=26.000,P=0.000,差异有统计学意义。进一步行两两比较,aMCI组与正常组比较识别阈值检测无统计学差异,P=0.359。早期AD组与aMCI组及正常组比较识别阈值检测有统计学差异,均P=0.000。提示早期AD患者即出现明显嗅觉识别障碍。尿AD7c-NTP检测,早期AD组2.21[0.27,4.24],aMCI组1.16[0.20,3.06],正常组0.20[0.20,1.11],三组比较Z=9.342,P=0.009。进一步行两两比较,早期AD组及aMCI组与正常组比较尿AD7c-NTP水平均有统计学差异(P=0.006,P=0.018),早期AD组与aMCI组比较尿AD7c-NTP水平无统计学差异,P=0.350。提示aMCI患者尿AD7c-NTP水平即有升高。认知功能MoCA总分、MMSE总分与嗅觉察觉阈值呈负相关,无统计学差异(P=0.185,P=0.405);与嗅觉识别阈值呈负相关,有统计学差异(P=0.000,P=0.000);与尿AD7C-NTP水平呈负相关,有统计学差异(P=0.017,P=0.003)。结论:嗅觉障碍及尿液AD7c-NTP变化在AD早期即可出现,有望成为阿尔茨海默病的早期新型生物学标志物。Objective:To investigate the value of olfactory function combined with urine AD7c-NTP detection in early diagnosis of Alzheimer's Disease.Methods:30 early AD,30 aMCI and 30 normal controls(NC)were recruited in the study.All participants were underwent neuropsychological assessment and olfactory test,including the Mini-Mental State Examination(MMSE),the Montreal cognitive assessment(MoCA),olfactory perception threshold and olfactory recognition threshold.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression changes of urine AD7c-NTP.Spearman rank correlation was used to evaluate the correlation between MMSE and MoCA scores with olfactory function and urine AD7c-NTP.Result:There was no statistically significant difference of the perception threshold among the three groups(early AD:-2.00[-2.00,-1.60];aMCI:-2.00[-2.00,-1.80];NC:-2.00[-2.00,-2.00];Z=3.678,P=0.159).There was statistically significant difference of the recognition threshold among the three groups(early AD:4.20[1.80,6.00];aMCI:2.00[1.00,3.00];NC:1.60[-0.80,2.90];F=26.000,P=0.000).There was statistically significant difference of urine AD7c-NTP levels among different groups(early AD:2.21[0.27,4.24];aMCI:1.16[0.20,3.06];NC:0.20[0.20,1.11],Z=9.342,P=0.009).The urine AD7c-NTP level in AD group and aMCI group were significantly higher than that of control group(P=0.006,P=0.018).MoCA and MMSE score was negatively related with the recognition threshold(P=0.000,P=0.000)and the urine AD7c-NTP(P=0.017,P=0.003).Conclusion:Olfactory impairment and urine AD7C-NTP expression changes can appear in the early stage of AD,which is expected to be a new biomarker for the early diagnosis of Alzheimer's disease.

关 键 词：阿尔茨海默病 遗忘型轻度认知功能障碍 嗅觉测试 阿尔茨海默病相关神经丝蛋白AD7c-NTP 

分 类 号：R741.04[医药卫生—神经病学与精神病学]