【摘要】 目的探讨尿液阿尔茨海默病相关神经丝蛋白(AD7c-NTP)表达变化对不同类型痴呆的诊断价值。方法分别采用简易智能状态检查量表(MMSE)和蒙特利尔认知评价量表(Mo CA)评价阿尔茨海默病(AD)、遗忘型轻度认知损害(a MCI)、额颞叶痴呆(FTD)和血管性痴呆(Va D)患者认知功能,酶联免疫吸附试验检测尿液AD7c-NTP表达变化,Spearman秩相关分析评价不同类型痴呆患者尿液AD7c-NTP水平与MMSE和Mo CA评分的相关性,受试者工作特征曲线(ROC曲线)计算尿液AD7c-NTP诊断痴呆之灵敏度、特异度和准确率。结果不同类型痴呆患者尿液AD7c-NTP水平差异有统计学意义(P=0.000),其中AD组、a MCI组、FTD组均高于对照组(P=0.000,0.029,0.005),中至重度AD组患者尿液AD7c-NTP水平高于轻度AD组,但未达到统计学意义(P=0.359)。相关分析显示,仅轻度AD组患者尿液AD7c-NTP水平与Mo CA评分呈负相关(rs=-0.506,P=0.016)。ROC曲线下面积为0.838(95%CI:0.732~0.945,P=0.000),诊断阿尔茨海默病的灵敏度和特异度分别为70.20%和90%,所对应的尿液AD7c-NTP临界值为2.32 ng/ml。约70.18%(40/57)的AD组、63.33%(19/30)的a MCI组和45.95%(17/37)的FTD组患者尿液AD7c-NTP表达异常(>2.32 ng/ml)。结论尿液AD7c-NTP表达变化在痴呆患者早期诊断和病情评价中具有重要临床参考价值。更多还原

【Abstract】 Objective To investigate the value of Alzheimer- associated neuronal thread protein(AD7c-NTP) level in urine for diagnosing dementia.Methods Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(Mo CA) were applied to evaluate cognitive function of all subjects.Enzyme-linked immunosorbent assay(ELISA) was used to detect the expression changes of urine AD7c-NTP. Spearman rank correlation was used to evaluate the correlation of urine AD7c-NTP with MMSE andMo CA scores. Receiver operating characteristic(ROC) curve was used to estimate the sensitivity,specificity and accuracy rate of AD7c-NTP on diagnosing dementia.Results There were 57 cases withAlzheimer’s disease(AD), 30 cases with amnesic mild cognitive impairment(a MCI), 37 cases withfrontotemporal dementia(FTD), 32 cases with vascular dementia(Va D) and 20 normal controls. There wasstatistically significant difference of urine AD7c-NTP levels among different groups(P = 0.000). The levelsof urine AD7c-NTP in AD group, a MCI group and FTD group were significantly higher than that of controlgroup(P = 0.000, 0.029, 0.005). The level of urine AD7c-NTP in moderate to severe AD group was higherthan that of mild AD group, but there was no significant difference(P = 0.359). The level of urine AD7c-NTP was negatively related with Mo CA score in mild AD group(rs=- 0.506, P = 0.016), and there was nosignificant correlation of urine AD7c-NTP with MMSE and Mo CA scores in moderate to severe AD group(P > 0.05, for all). In ROC analysis, area under the curve(AUC) was 0.838(95%CI: 0.732-0.945, P =0.000), with 70.20% sensitivity and 90% specificity, and the critical value for diagnosing AD was2.32 ng/ml of urine AD7c- NTP. There were 70.18%(40/57) of AD patients, 63.33%(19/30) of a MCIpCaotinecnltuss iaonnds 45.95%(17/37) of FTD patients had abnormal levels of urine AD7c- NTP(> 2.32 ng/ml).AD7c- NTP level in urine has important clinical value in early diagnosis and conditionassessment of patients with dementia.更多还原