尿阿尔茨海默病相关神经丝蛋白与外周血 CD45RA+T 细胞亚群联合检测早期诊断阿尔茨海默病

摘要

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 0.05)；③尿 AD7c-NTP 在 AD 组和 MCI 组中的含量较对照组显著升高(P 0.05)；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。%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 0.05).The content of urinary AD7c-NTP in AD and MCI groups were markedly higher than that of control 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.