【摘要】 目的：探讨阿尔茨海默病（AD）及轻度认知功能障碍（MCI）患者血液中单核细胞的β淀粉样蛋白42(Aβ42)吞噬功能研究，为AD的诊治提供新的方向。方法：选择2016年12月至2019年12月广西壮族自治区江滨医院就诊的AD患者（AD组）、MCI患者（MCI组）和体检健康志愿者（NC组）各56例，采用流式细胞术分析外周血中单核细胞（CD14+CD16-、CD14+CD16+和CD14-CD16+）的Aβ42吞噬功能，比较不同年龄组[20～45岁（低龄组）、46～65岁（正常组）、和66～80岁（高龄组）]AD患者外周血单核细胞的Aβ42吞噬功能变化；ELISA检测血液和脑脊液中Aβ42水平；Pearson相关分析检测外周血单核细胞的Aβ42吞噬功能与血液和脑脊液Aβ42水平的相关性。结果：与NC组和MCI组相比，AD患者总单核细胞和单核细胞亚群（CD14+CD16~-、CD14~+CD16~+和CD14-CD16~+）的Aβ42吞噬功能显著降低（P<0.05）,MCI组和NC组间差异无统计学意义；AD高年龄组患者外周血总单核细胞和单核细胞亚群（CD14~+CD16-、CD14~+CD16~+和CD14~-CD16~+）的Aβ42吞噬功能显著降低（P均<0.05）；与NC组和MCI组相比，AD患者血液和脑脊液中Aβ42水平显著降低（P<0.05）,MCI组与NC组相比下降不显著；外周血中单核细胞CD14~+CD16~-、CD14+CD16+亚群与血液Aβ42水平呈正相关（r=0.412,P=0.012;r=0.356,P=0.032）。结论：AD患者外周血单核细胞Aβ42吞噬功能下降，提示其在AD的发生发展中发挥重要作用，为AD的诊治提供了潜在靶点。更多还原

【Abstract】 Objective:To investigate the phagocytic function of β-amyloid 42(Aβ42)in blood monocytes of Alzheimer’s disease(AD)and mild cognitive impairment(MCI)patients,and to provide a new therapeutic direction for the diagnosis and treatment of AD.Methods:56 cases of AD patients(AD group),MCI patients(MCI group)and healthy subjects(NC group)admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from December 2016 to December 2019 were selected;analysis of peripheral blood mononuclear cells(CD14+CD16-,CD14+CD16+and CD14-CD16+)Aβ42 phagocytosis by using flow cytometry;comparing different age groups[20～45 year old(young group),46～65 year old(normal group),and 66～80 year old(older group)]of peripheral blood mononuclear cells Aβ42 phagocytosis changes in patients with AD;Aβ42 level in blood and cerebrospinal fluid were detected by ELISA;correlation between phagocytosis of Aβ42 in peripheral blood mononuclear cell and Aβ42 level in blood and cerebrospinal fluid was analyzed by Pearson correlation.Results:Compared with NC and MCI groups,phagocytosis of Aβ42 in total monocytes and monocyte subsets(CD14+CD16-,CD14+CD16+and CD14-CD16+)in AD patients were significantly decreased(P<0.05),but there was no significant difference between MCI group and NC group;phagocytosis of Aβ42 in total monocytes and monocyte subsets(CD14+CD16-,CD14+CD16+and CD14-CD16+)in peripheral blood of patients with AD in high age group were significantly decreased(all P<0.05);compared with NC and MCI groups,levels of Aβ42 in blood and cerebrospinal fluid in AD patients were significantly decreased(P<0.05),but not significantly decreased in MCI group compared with NC group. CD14+CD16-and CD14+CD16+subsets in peripheral blood were positively correlated with blood Aβ42 level(r=0.412,P=0.012;r=0.356,P=0.032).Conclusion:The decreased phagocytosis of Aβ42 in peripheral blood of AD patients suggests that Aβ42 plays an important role in occurrence and development of AD,and provides a potential therapeutic target for the diagnosis and treatment of AD.更多还原