簇集蛋白、转甲状腺素蛋白在阿尔茨海默病患者中的表达水平及临床意义  

Expression level and clinical significance of cluster protein and transthyroxine protein in patients with Alzheimer's disease

作　　者：孟凤珠 张燕丽[1] 姜珊 张帆[1] 王岑 温凯[1] Meng Fengzhu;Zhang Yanli;Jiang Shan;Zhang Fan;Wang Cen;Wen Kai(Department of Geriatrics,Xi'an First Hospital,Shaanxi Province,Xi’an 710002,China)

机构地区：[1]西北大学第一附属医院/西安市第一医院老年病科,710002

出　　处：《疑难病杂志》2022年第1期31-35,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省科学技术研究发展计划项目(2017JQ8081)。

摘　　要：目的探讨簇集蛋白、转甲状腺素蛋白在阿尔茨海默病(AD)患者中的水平变化及临床意义。方法收集2015年3月—2020年3月西北大学第一附属医院收治的AD患者80例为AD组,根据简易精神状态评价量表(MMSE)评分分为轻度亚组(n=33)、中度亚组(n=26)和重度亚组(n=21),并于同一时期随机选取40例血管性痴呆(VD)患者作为VD组和40例健康体检者作为健康对照组。采用酶联免疫吸附法检测各组血清簇集蛋白、转甲状腺素蛋白、β淀粉样蛋白40(Aβ40)和Aβ42水平。采用Pearson积矩相关分析血清簇集蛋白、转甲状腺素与MMSE评分的相关性,绘制受试者工作特征曲线(ROC)评估其对AD的诊断效能。结果血清簇集蛋白水平比较,AD组>VD组>健康对照组(F/P=76.068/0.000),血清转甲状腺素蛋白水平比较,AD组<VD组<健康对照组(F/P=133.098/0.000)。AD组Aβ42水平及Aβ42/Aβ40比值均低于VD组和健康对照组(P<0.05),而Aβ40水平比较差异无统计学意义(P>0.05)。AD患者随病情程度加重血清簇集蛋白水平逐渐升高(F/P=126.346/0.000),血清转甲状腺素蛋白、Aβ42水平及Aβ42/Aβ40比值逐渐降低(F/P=627.128/0.000、56.179/0.000、20.726/0.000)。AD患者血清簇集蛋白与Aβ42、Aβ42/Aβ40比值、MMSE评分呈负相关(r=-0.811、-0.795、-0.762,P<0.05),血清转甲状腺素蛋白与Aβ42、Aβ42/Aβ40比值、MMSE评分呈正相关(r=0.783、0.751、0.718,P<0.05)。ROC曲线分析结果显示,血清簇集蛋白、转甲状腺素蛋白诊断AD的AUC为0.812、0.791,截断值为103.28 mg/L、382.67 mg/L,敏感度为0.81、0.78,特异度为0.73、0.72;二者联合诊断AD的AUC为0.916,大于单一指标检测(Z=3.198,P<0.05),敏感度、特异度分别为0.89、0.80。结论AD患者血清簇集蛋白表达上调,转甲状腺素蛋白水平表达下调,2指标均与疾病的严重程度有关,早期联合检测对辅助临床诊断AD及评估病情严重性有重要价值。Objective To investigate the changes and clinical significance of cluster protein and transthyroxine protein in patients with Alzheimer's disease(AD).Methods Eighty patients with AD treated in the First Affiliated Hospital of Northwest University from March 2015 to March 2020 were collected as ad group.They were divided into mild subgroups(n=33),moderate subgroups(n=26)and severe subgroups(n=21)according to the score of mini mental state evaluation scale(MMSE).At the same time,40 patients with vascular dementia(VD)were randomly selected as VD group and 40 healthy people as healthy control group.Serum cluster protein,transthyroxine protein andβAmyloid 40(Aβ40)and Aβ42 level.Pearson product moment correlation was used to analyze the correlation between serum cluster protein,transthyroxine and MMSE score,and the receiver operating characteristic curve(ROC)was drawn to evaluate its diagnostic efficacy for AD.Results The levels of serum cluster protein in AD group>VD group>healthy control group(F/P=76.068/0.000),and the levels of serum transthyroxine protein in AD group<VD group<healthy control group(F/P=133.098/0.000).AD group Aβ42 level and Aβ42/Aβ40 was lower than that in VD group and healthy control group(P<0.05).And There was no significant difference in Aβ40 levels(P>0.05).With the aggravation of the disease,the level of serum cluster protein increased gradually(F/P=126.346/0.000),serum transthyroxine protein and Aβ42 level and Aβ42/Aβ40 ratio decreased gradually(F/P=627.128/0.000,56.179/0.000,20.726/0.000).Serum cluster protein and a in patients with ADβ42、Aβ42/Aβ40 ratio and MMSE score were negatively correlated(r=-0.811,-0.795,-0.762,P<0.05)β42、Aβ42/Aβ40 ratio and MMSE score were positively correlated(r=0.783,0.751,0.718,P<0.05).ROC curve analysis showed that the AUC of serum cluster protein and transthyroxine protein in the diagnosis of AD was 0.812 and 0.791,the cut-off values were 103.28 mg/L and 382.67 mg/L,the sensitivity was 0.81 and 0.78,and the specificity was 0.73 and 0.72.The AUC

关 键 词：阿尔茨海默病 簇集蛋白 转甲状腺素蛋白 临床意义 

分 类 号：R743.9[医药卫生—神经病学与精神病学]