血清IL-33在阿尔茨海默病、轻度认知障碍、主观认知下降患者中的表达水平及意义  

Expression Level of Serum I L-33 in Patients with Alzheimer’s Disease,Mild Cognitive Impairment and Subjective Cognitive Decline and its Clinical Significance

作　　者：戴莉莉 周涛 卡力比努尔·赛买提 宋雨影 谢伊代·阿卜迪米吉提 宋向新 哈斯也提·依不来音[2,3] DAI Li-li;ZHOU Tao;Kalibinuer Saimaiti;SONG Yu-ying;Xieyidai Abudimiti;SONG Xiang-xin;Hasiyeti Yibulaiyin(Department of Clinical Psychology,Karamay Hospital,People’s Hospital of XinjiangUygur Autonomous Region/Karamay Central Hospital,Karamay 834000,China;Department of Neurology,the Second Affiliated Hospital of Xinjiang MedicalUniversity,Urumqi 830000,China;Xinjiang Key Laboratory ofNervous System Disease Research,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院克拉玛依医院(克拉玛依市中心医院)临床心理科,新疆克拉玛依834000 [2]新疆医科大学第二附属医院神经内科,乌鲁木齐830000 [3]新疆神经系统疾病研究重点实验室,乌鲁木齐830000

出　　处：《南昌大学学报（医学版）》2024年第4期35-42,共8页Journal of Nanchang University：Medical Sciences

基　　金：新疆维吾尔自治区自然科学基金资助项目(2023D01C118)。

摘　　要：目的比较血清白介素-33(IL-33)在阿尔茨海默病(AD)、轻度认知障碍(MCI)、主观认知下降(SCD)患者中的水平变化差异,探讨IL-33与认知功能的相关性,并评价血清IL-33的诊断价值。方法选取在新疆医科大学第二附属医院住院的AD患者46例、MCI患者42例、SCD患者51例及同期健康体检人群[健康对照(HC)组50例]。对所有受试者进行神经心理学评估,并用ELISA法检测血清IL-33的水平。比较4组的一般资料和外周血常规生化资料,分析血清IL-33水平与简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分的相关性,采用逻辑回归分析AD的影响因素,并绘制ROC曲线分析IL-33的诊断价值。结果1)4组的血清IL-33水平差异有统计学意义(P<0.05)。与HC组相比,AD组、MCI组IL-33水平较低(P<0.05);与SCD组相比,AD组、MCI组IL-33水平较低(P<0.05);与MCI组相比,AD组IL-33水平较低(P<0.05);SCD组与HC组IL-33水平差异无统计学意义(P>0.05)。2)血清IL-33水平与MMSE(r=0.578,P<0.001)、MoCA(r=0.583,P<0.001)呈正相关。3)多因素Logitic回归分析提示受教育程度(OR=0.385,P<0.05)、同型半胱氨酸(Hcy)(OR=1.142,P<0.05)、IL-33(OR=0.902,P<0.05)是AD发生的影响因素;血清IL-33水平诊断AD的曲线下面积为0.865(95%CI 0.786~0.943),灵敏度为87.0%,特异度为80.0%,CUToff为49.135(P<0.05);联合受教育程度、血清Hcy水平、血清IL-33水平诊断AD的曲线下面积为0.894(95%CI 0.825~0.962),灵敏度为89.1%,特异度为83.7%(P<0.05)。结论1)血清IL-33在AD、MCI、SCD患者和健康人群中的表达水平不同,在AD患者中水平最低,在健康人群中水平最高;IL-33对SCD发生风险的影响不大。2)血清IL-33表达水平与其认知功能呈正相关。3)血清IL-33可能是AD发生的保护因素,对AD的发生有较好的诊断价值,有望成为AD辅助诊断的生物标记物。4)受教育程度、血清IL-33水平、血清Hcy水平均是AD发生的影响因素,联合多因素对AD的诊断效�Objective To compare the levels of serum interleukin-33(IL-33)in patients with Alzheimer’s disease(AD),mild cognitive impairment(MCI)and subjective cognitive decline(SCD),to explore the correlation between IL-33 and cognitive function,and to evaluate the diagnostic value of serum IL-33.Methods In this case-control study,46 patients with AD,42 patients with MCI,51 patients with SCD and 50 healthy participants(Health Control)were selected from the Second Affiliated Hospital of Xinjiang Medical University.Neuropsychological assessment was performed on all the subjects and serum IL-33 levels were measured by ELISA.The general information and peripheral blood routine biochemical data of the 4 groups were compared respectively,and the correlation between the serum IL-33 level and the scores of the Mini Mental State Examination(MMSE)and the Montreal Cognitive Assessment(MoCA)was analyzed.The risk factors of AD were analyzed by logistic regression,and the diagnostic value of IL-33 was analyzed by ROC curve Results 1)The difference in the serum IL-33 levels among the 4 groups was statistically significant(P<0.05).Compared with the HC group,the IL-33 levels were lower in the AD and MCI groups,and the difference was statistically significant(P<0.05);compared with the SCD group,the IL-33 levels were lower in the AD and MCI groups,and the difference was statistically significant(P<0.05);compared with the MCI group,the IL-33 level was lower in the AD group,and the difference was statistically significant(P<0.05);the difference of the IL-33 levels in the SCD and HC groups was not statistically significant(P>0.05).2)The serum IL-33 levels were positively correlated with MMSE(r=0.578,P<0.001)and MoCA(r=0.583,P<0.001).3)Multivariate logistic regression analysis suggested that education level(OR=0.385,P<0.05),homocysteine(OR=1.142,P<0.05),IL-33(OR=0.902,P<0.05)were the risk factors for the occurrence of AD;the area under the curve of serum IL-33 for the diagnosis of AD was 0.865(95%CI 0.786-0.943),with a sensitivity of 87.0%,a sp

关 键 词：阿尔茨海默病 轻度认知障碍 主观认知下降 白介素-33 认知功能 

分 类 号：R741[医药卫生—神经病学与精神病学]