CAJ | 학술논문

目的：探讨尿阿尔茨海默病相关神经丝蛋白(Alzheimer disease related neural thread protein,AD7c-NTP)与外周血淋巴细胞 CD45RA+ T 亚型联合检测在阿尔茨海默病(AD)早期诊断中的价值。方法根据 Peterson制订的轻度认知功能障碍(MCI)诊断标准和美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)有关 AD 的诊断标准,选取 AD 患者32例(AD 组),MCI 患者30例(MCI 组),另选60例健康者作为对照组。对比各组尿 AD7c-NTP 与CD45RA+ T 细胞亚群变化及诊断价值。结果①CD45RA+ T 蛋白表达水平在 AD 组和 MCI 组显著低于对照组(P <0.01)；②CD45RA+ T 在 AD 组和 MCI 组中的相对表达水平较对照组显著降低(P <0.01),AD 组与 MCI 组间差异无统计学意义(P >0.05)；③尿 AD7c-NTP 在 AD 组和 MCI 组中的含量较对照组显著升高(P <0.01),AD 组与MCI 组间差异无统计学意义(P >0.05)；④CD45RA+ T 与 AD7c-NTP 联合诊断具有较好的敏感度、特异度、阳性预测值、阴性预测值。结论 AD7c-NTP 与 CD45RA+ T 联合检测是诊断 AD 早期病变的较好指标,提升二者单独应用时的预测价值,为 AD 早期诊断及疗效监测提供参考。
목적：탐토뇨아이자해묵병상관신경사단백(Alzheimer disease related neural thread protein,AD7c-NTP)여외주혈림파세포 CD45RA+ T 아형연합검측재아이자해묵병(AD)조기진단중적개치。방법근거 Peterson제정적경도인지공능장애(MCI)진단표준화미국정신장애진단여통계수책제4판(DSM-Ⅳ)유관 AD 적진단표준,선취 AD 환자32례(AD 조),MCI 환자30례(MCI 조),령선60례건강자작위대조조。대비각조뇨 AD7c-NTP 여CD45RA+ T 세포아군변화급진단개치。결과①CD45RA+ T 단백표체수평재 AD 조화 MCI 조현저저우대조조(P <0.01)；②CD45RA+ T 재 AD 조화 MCI 조중적상대표체수평교대조조현저강저(P <0.01),AD 조여 MCI 조간차이무통계학의의(P >0.05)；③뇨 AD7c-NTP 재 AD 조화 MCI 조중적함량교대조조현저승고(P <0.01),AD 조여MCI 조간차이무통계학의의(P >0.05)；④CD45RA+ T 여 AD7c-NTP 연합진단구유교호적민감도、특이도、양성예측치、음성예측치。결론 AD7c-NTP 여 CD45RA+ T 연합검측시진단 AD 조기병변적교호지표,제승이자단독응용시적예측개치,위 AD 조기진단급료효감측제공삼고。
Objective To investigate the significance of the combined detection of urinary Alzheimer disease related neural thread protein (AD7c-NTP)and peripheral blood CD45RA+ T lymphocyte subsets in early diagnosis of Alzheimer disease.Methods According to the clinical criteria for the diagnosis of mild cognitive impairment (Peterson 2004b)and American Diagnostic criteria and Statistical Manual of mental disorders Ⅳ for Alzheimer disease,62 patients were enrolled in this study and then grouped into AD group (n = 32)and mild cognitive impairment group (MCI group,n =30).Sixty healthy individuals were recruited as control group.Then,the urinary AD7c-NTP and peripheral blood CD45RA+ T lymphocyte subsets were determined and compared. Results The expression of CD45RA in AD and MCI groups were significantly less than that in control group (P <0.01)and the percentages of CD45RA+ CD4 + T cells in AD and MCI groups also decreased significantly as compared with that of control group (P<0.01),but no significant differences were found between AD and MCI group (P >0.05).The content of urinary AD7c-NTP in AD and MCI groups were markedly higher than that of control group (P <0.01),while there was no significant difference between AD and MCI group (P >0.05 ).The combined detection of urinary AD7c-NTP and peripheral blood CD45RA+ T lymphocyte subsets had better diagnostic sensitivity,specificity,positive predictive value and negative predictive value than either detection alone.Conclusion The combined detection of urinary AD7c-NTP and peripheral blood CD45RA+ T lymphocyte subsets is a reliable method for early diagnosis of Alzheimer disease, since the combined method can enhance the predictive value as compared with the detection alone.It suggests that the combined detection may provide a theoretical basis for early diagnosis and monitor of AD.