鞘内合成相关标志物在认知功能障碍及各类痴呆性疾病中的应用价值  

Application value of intrathecal synthetic related markers in cognitive dysfunction and various dementia diseases

作　　者：刘亚楠[1,2,3] 姜文灿 王晨旭 邵春青 张盟略[1] 贾雯雅 黄雨萱 翟璟淳 廖佳怡 张国军 LIU Yanan;JIANG Wencan;WANG Chenxu;SHAO Chunqing;ZHANG Menglue;JIA Wenya;HUANG Yuxuan;ZHAI Jingchun;LIAO Jiayi;ZHANG Guojun(Department of Clinical Diagnosis,Laboratory of Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;National Engineering Research Center for Beijing Biochip Technology,Beijing 100070,China;NMPA Key Laboratory for Quality Control for In Vitro Diagnostic,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院实验诊断中心,北京100070 [2]北京市免疫试剂临床工程技术研究中心,北京100070 [3]国家药监局体外诊断试剂质量控制重点实验室,北京100070

出　　处：《国际检验医学杂志》2024年第17期2076-2080,共5页International Journal of Laboratory Medicine

基　　金：国家重点研发计划(2022 YFC2403500);北京市科学技术协会青年人才托举工程(BYESS2022170);北京市医院管理中心登峰计划(DFL20220505)。

摘　　要：目的评估鞘内合成相关标志物在轻度认知功能障碍(MCI)、阿尔茨海默病(AD)和其他类型痴呆患者中的应用价值。方法回顾性收集首都医科大学附属北京天坛医院2019年6月至2023年7月577例临床确诊为MCI(MCI组,178例)、AD(AD组,131例)、其他类型痴呆(其他类型组,268例)患者的临床资料,查询各组寡克隆区带电泳(OCB)和24 h鞘内蛋白合成率(ISR),比较各组不同指标的差异,评估相关指标在不同疾病中的鉴别诊断价值。结果与AD组及其他类型组比较,AD组患者女性占比更高、年龄多分布在>50~70岁,脂代谢异常的发生率更高,差异有统计学意义(P<0.05)。不同疾病组血清IgG寡克隆区带[OB(S)]、脑脊液白蛋白、血清白蛋白和脑脊液IgG比较,差异均有统计学意义(P<0.05)。脑脊液特异IgG寡克隆区带[SOB(CSF)]阳性患者IgG指数和ISR高于阴性和弱阳性患者,差异均有统计学意义(P<0.001)。IgG指数和ISR呈正相关(r=0.878,P<0.001)。结论IgG指数、SOB(CSF)和24 h ISR等鞘内合成相关标志物在认知功能障碍及各类痴呆性疾病的诊断中具有协同作用,可共同用于疾病的诊断。Objective To evaluate the value of intrathecal synthetic related markers in patients with mild cognitive impairment(MCI),Alzheimer′s disease(AD),and other types of dementia.Methods Retrospectively collect the clinical data of 577 patients diagnosed with MCI(MCI group,178 cases),AD(AD group,131 cases),and other types of dementia(other types group,268 cases)from June 2019 to July 2023 in Beijing Tiantan Hospital,Capital Medical University.Oligoclonal zone electr ophoresis(OCB)and 24 h intrathecal protein synthesis rate(ISR)of each group were investigated,and the difference of different indexes among the groups was compared to evaluate the value of related indexes in the differential diagnosis of different diseases.Results Compared with AD group and other groups,AD group had a higher proportion of females,more patients were>50-70 years old,and the incidence of abnormal lipid metabolism was higher,with statistical significance(P<0.05).There were significant differences in OB(S),cerebrospinal fluid albumin,serum albumin and cerebrospinal fluid IgG in different disease groups(P<0.05).IgG index and ISR in patients with positive SOB(CSF)were higher than those in negative and weakly positive patients,and the differen ces were statistically significant(P<0.001).IgG index was positively correlated with ISR(r=0.878,P<0.001).Conclusion Intrathecal synthetic markers such as IgG index,SOB(CSF)and 24 h ISR have synergistic effects in the di agnosis of cognitive dysfunction and various dementias,which can be collectively utilized in the diagnosis of diseases.

关 键 词：寡克隆区带电泳 24 h鞘内蛋白合成率 阿尔茨海默病 认知功能障碍 

分 类 号：R446.1[医药卫生—诊断学] R749.16[医药卫生—临床医学]