阿尔茨海默病患者血清趋化因子CX3CL1水平与临床相关性  

Serum CX3CL1 levels and their clinical significance in Alzheimer's disease patients

作　　者：周佳君 魏孟丽 吴宝亮 罗涟 邵森 Zhou Jiajun;Wei Mengli;Wu Baoliang;Luo Lian;Shao Sen(Department of Neurology,Affiliated Hangzhou Xiri Hospital,Zhejiang University School of Medicine,Hangzhou 310023,China;Department of Neurology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China;Department of Radiology,Affiliated Hangzhou Xixi Hospital,Zhejiang University School of Medicine,Hangzhou 310023,China)

机构地区：[1]浙江大学医学院附属杭州西溪医院神经内科,杭州310023 [2]郑州大学附属郑州中心医院神经内科,郑州450000 [3]浙江大学医学院附属杭州西溪医院放射科,杭州310023

出　　处：《中华老年医学杂志》2024年第4期444-449,共6页Chinese Journal of Geriatrics

基　　金：浙江省中医药科学研究基金项目A类(2022ZA145);浙江省医药卫生科技项目(2022KY1025)。

摘　　要：目的探讨阿尔茨海默病(AD)患者血清趋化因子CX3CL1水平与临床特征的关系。方法选取2018年9月至2022年6月在浙江大学医学院附属杭州西溪医院就诊的AD患者44例、轻度认知功能障碍(MCI)患者32例及健康对照组33例,采用免疫比浊法检测各组血清CX3CL1水平,运用简易智能精神状态检查量表(MMSE)评估AD患者的认知障碍严重程度,行磁共振成像(MRI)评估测量脑萎缩情况。分析AD患者CX3CL1水平与病程、病情轻重、脑萎缩程度的相关性。结果AD组血清CX3CL1水平低于对照组[(0.45±0.10)ng/ml比(0.51±0.07)ng/ml,P=0.01]及MCI组[(0.45±0.10)ng/ml比(0.57±0.08)ng/ml,P<0.001]。MCI组则高于对照组[(0.57±0.08)ng/ml比(0.51±0.07)ng/ml,P=0.03]。MMSE评分≤10分的AD患者血清CX3CL1水平低于MMSE>10分的患者[(0.40±0.07)ng/ml比(0.47±0.11)ng/ml;t=-2.57,P<0.05]。存在脑萎缩的AD患者血清CX3CL1水平低于无脑萎缩的AD患者[(0.41±0.09)ng/ml比(0.51±0.08)ng/ml,t=-3.79,P<0.05]。相关性分析提示AD患者血清CX3CL1与MMSE评分呈正相关(r=0.417,P<0.05)。病程时间及MRI脑容积线性指标哈氏值、第三脑室指数及鞍上池指数与血清CX3CL1水平呈负相关(r=-0.638、-0.335、-0.562、-0.393,均P<0.05)。而MCI患者血清CX3CL1水平与病程,MMSE评分及脑容积线性指数无明显相关性(r=-0.120、-0.065、0.129、-0.061、0.035;均P>0.05)。血清CX3CL1预测AD的ROC下面积为0.83(95%CI:0.73~0.92),最佳诊断界值为0.48ng/mL,其预测敏感度为66%,特异度为91%。结论AD患者血清CX3CL1降低,并且与病情严重程度及脑萎缩有关;对MCI患者检测血清CX3CL1对AD有一定预测价值。Objective To examine the relationship between serum CX3CL1 levels and clinical features of Alzheimer's disease(AD)patients.Methods44 AD patients admitted to affiliated Hangzhou Xixi hospital between September 2018 and June 2022 were assigned into the AD group,32 patients with mild cognitive impairment(MCI)entered the MCI group and 33 healthy people served as the control group.A turbidimetric immunoassay was used to measure serum CX3CLl levels of the groups.Cognitive function was evaluated by the mini-mental state examination(MMSE).Magnetic resonance imaging(MRI)was used to measure brain atrophy.The correlation of the CX3CL1 level with the course of disease,disease severity and the degree of brain atrophy in AD patients was analyzed.Results AD Patients had lower serum CX3CL1 levels compared with the control group[(0.45±0.10)ng/ml vs.(0.51±0.07)ng/ml,P=0.01]and the MCI group[(0.45±0.10)ng/ml-vs.(0.57±0.08)ng/ml,P<0.001].Serum CX3CL1 levels in the MCI group were significantly higher than those in the control group[(0.57±0.08)ng/ml vs.(0.51±0.07)ng/ml,P=0.03].Serum CX3CL1 levels were significantly lower in AD patients with MMSE<10 than those with MMSE>10[(0.40±0.07)ng/ml vs.(0.47±0.11)ng/ml,t=-2.57,P<0.05].AD patients with brain atrophy had lower CX3CL1 levels than those without brain atrophy[(0.41±0.09)ng/ml us.(0.51±0.08)ng/ml,t=-3.79,P<0.05].Correlation analysis showed that there was a positive correlations between the serum CX3CL1 level and the MMSE score(r=0.417,P<0.05).The disease duration,the linear measures of the brain volume including the Huckman number,the third ventricular index and the suprasellar cistern area ratio were negatively correlated with serum CX3CL1 levels(r=-0.638,-0.335,-0.562,-0.393,respectively,all P<0.05).However,serum CX3CL1 levels had no clear correlation with disease duration,MMSE score and linear measures of the brain volume in MCI patients(r=-0.120,-0.065,0.129,-0.061,0.035,respectively,all P>0.05).The area under the ROC-plot for CX3CL1 was 0.83(95%CI:0.73-0.92).The optimal

关 键 词：阿尔茨海默病 认知障碍 CX3CL1 脑萎缩 

分 类 号：R749.16[医药卫生—神经病学与精神病学]