【摘要】 目的　探索可信的阿尔茨海默病 (AD)临床诊断的生化指标。方法　用ELASA 双酶底物循环扩增技术检测AD(5 2例 )、血管性痴呆 (VD ,46例 )、非痴呆性神经系统疾病 (non AD ,37例 )和正常对照组 (5 6例 )的脑脊液 (CSF)中tau蛋白和磷酸化tau(p tau)含量。结果　测定经国外尸检组织病理学确诊的ADCSF样品组的总tau和p tau含量 ,显著高于VD组、non AD组及正常对照组 ;二者的灵敏度、特异性、可靠性及与VD的鉴别率分别为 90 0 %、79 0 %、82 8%、6 6 7%和 93 3%、89 5 %、90 8%、83 3%。测定国内从多家医院收集的CSF样品组的总tau和p tau的含量 ,亦呈类似结果。其p tau的灵敏度、特异性、可靠性及与VD鉴别率分别为 77 3%、85 4 %、83 7%和 71 4 %。结论　CSFp tau含量测定是可信的AD临床诊断生化指标。更多还原

【Abstract】 Objective To search for reliable and quantitative biochemical marker for diagnosis of Alzheimer disease. Methods ELISA-double enzyme amplification assay was used to detect the total tau and abnormally hyperphosphorylated (p-tau) in cerebrospinal fluid specimens of patients with Alzheimer disease (AD, N=52,30 from the Netherlands and 22 from Wuhan and Haikou, China), vascular dementia (VD, N=46, 18 from the Netherlands and 28 from Haikou), and non-neurological disease (N=37, 13 from the Netherlands and 24 from Haikou) and of normal elderly controls (N=56,26 from the Netherlands, and 30 from Wuan and Haikou). Results The measurement of CSF specimens from Netherlands Brain Bank showed that the levels of total tau and p-tau in CSF specimens of AD patients were significantly higher than those in CSF of patients with VD and non-dementia neurological disorders, and of age-matched non-neurological normal controls. With CSF tau ≥370 pg/ml as the marker for diagnosis of AD, the sensitivity, specificity, reliability as well as differentiation rate of AD from VD were 90.0%, 79.0%, 82.8% and 66.7%, respectively. With CSF p-tau≥120 pg/ml as the marker for diagnosis of AD, the sensitivity, specificity, reliability as well as differentiation rate of AD from VD were 93.3%?89.5%?90.8%?and 83.3% respectively. The measurement of total and phosphorylated taus in CSF specimens of AD and non-AD patients and normal controls collected in China showed the similar results; and the sensitivity, specificity, reliability as well as differentiation rate of AD from VD were 77.3%?85.4%?83.7% and 71.4% with CSF tau ≥120 pg/ml as the marker for diagnosis of AD. There was no correlation between CSF tau and p-tau and age, sex, and seriousness of disease. Conclusion Increased phosphorylated tau in human cerebrospinal fluid is a reliable biomarker for diagnosis of Alzheimer disease.更多还原