血液NLRP3 Lp-PLA2联合CER对阿尔茨海默病的诊断价值及与UPDRS功能的相关性  

Diagnostic value of serum NLRP3,Lp-PLA2 combined with CER in Alzheimer’s disease and its correlation with UPDRS function

作　　者：朱琳琳[1] 季晶 朱婷[1] 王媛媛 陈晓宏[1] ZHU Linlin;JI Jing;ZHU Ting;WANG Yuanyuan;CHEN Xiaohong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院,上海200021

出　　处：《中国实用神经疾病杂志》2022年第11期1336-1341,共6页Chinese Journal of Practical Nervous Diseases

基　　金：上海市卫生和计划生育委员会科研课题计划(编号:20203Y3256)。

摘　　要：目的探讨血清NOD样受体家族蛋白3(NLRP3)、相关磷脂酶A2(Lp-PLA2)联合血浆铜蓝蛋白(CER)对阿尔茨海默病(AD)的诊断价值及与帕金森病综合评分量表(UPDRS功能)的相关性。方法选取2020-04—2022-04在上海中医药大学附属曙光医院接受治疗的122例AD患者(AD患者组),另选取同期体检的健康受试者58例为健康对照组。AD患者组患者以临床痴呆评定量表(CDR)判断病情严重程度,根据患者病情分为轻-中度AD组及重度AD组。观察各组血液上述指标水平、MMSE评分及UPDRS功能总评分,采用ROC曲线分析血清NLRP3、Lp-PLA2及血浆CER对AD的诊断价值,采用Pearson相关系数分析血清NLRP3、Lp-PLA2及血浆CER与UPDRS功能的相关性。结果AD患者组血清NLRP3、Lp-PLA2水平较健康对照组显著升高,AD患者组血浆CER水平较健康对照组显著降低(均P<0.001);AD患者组MMSE评分较健康对照组显著降低,UPDRS功能各项评分及总评分较健康对照组显著升高(均P<0.001);随着AD患者病情程度的加剧,其血清NLRP3、Lp-PLA2水平呈明显升高趋势,血浆CER水平呈明显降低趋势(均P<0.001);重度AD组MMSE评分较轻-中度AD组显著降低,UPDRS功能各项评分及总评分均显著高于轻-中度AD组(均P<0.001)。ROC曲线分析显示3项指标联合检测曲线下面积明显高于NLRP3、Lp-PLA2、CER单项检测(AUC=0.914);血清NLRP3、Lp-PLA2水平均与UPDRS功能评分呈明显正相关,血浆CER水平与UPDRS功能评分呈明显负相关(均P<0.05)。结论与健康人群比较,AD患者NLRP3、Lp-PLA2、CER均呈异常表达,3项指标联合检测对临床诊断AD的效能较高,且3项指标与AD患者UPDRS功能评分存在相关性,后续可成为评估AD患者UPDRS功能的有效血液指标。Objective To investigate the diagnostic value of serum NOD-like receptor family protein 3(NLRP3),associated phospholipase A2(Lp-PLA2)and plasma ceruloplasmin(CER)indices in Alzheimer’s disease(AD)and their correlation with Parkinson’s disease comprehensive scoring scale(UPDRS function).Methods A total of 122 AD patients diagnosed and treated in the Shuguang Hospital Affiliated to Shanghai University of Chinese Medicine from April 2020 to April 2022 were included in the AD patient group,and 58healthy subjects who received physical examination in our hospital during the same period were selected as the healthy control group.All AD patients received clinical dementia rating scale(CDR)to determine the severity of their disease,and subgroups were established according to the patient’s condition,which were mild/moderate AD group and severe AD group.Blood index levels,MMSE score and total UPDRS function score were observed in each groups.The diagnostic value of serum NLRP3,Lp-PLA2 and plasma CER in AD was analyzed by ROC curve.Pearson correlation coefficient was used to analyze the correlation between serum NLRP3,Lp-PLA2,CER and UPDRS function.Results The levels of serum NLRP3 and Lp-PLA2 in AD patients increased significantly than the healthy control group,and the levels of CER in AD patients decreased significantly than the healthy control group(all P<0.001).The MMSE score of AD patients decreased significantly than the healthy control group,and the UPDRS function score and total score of AD patients increased significantly than the healthy control group(all P<0.001).The levels of NLRP3 and Lp-PLA2 in serum of AD patients increased significantly,and the levels of CER in plasma decreased significantly(all P<0.001).MMSE score in severe AD group decreased significantly than that in mild/moderate AD group,and UPDRS function scores and total scores in severe AD group increased significantly than those in mild/moderate AD group(all P<0.001).ROC curve analysis showed that the area under the curve of three indexes combi

关 键 词：阿尔茨海默病 NOD样受体家族蛋白3 相关磷脂酶A2 铜蓝蛋白 UPDRS功能 诊断价值 相关性 

分 类 号：R749.16[医药卫生—神经病学与精神病学]