不同类型痴呆患者阿尔茨海默病相关神经丝蛋白水平和嗅觉功能差异的比较

摘要

Objective To explore the diagnostic value of Alzheimer-associated neuronal thread protein(AD7C-NTP)and olfactory function in the differentiation of three types of dementia,and to evaluate their clinical application value.Methods Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment(MoCA)were applied to evaluate cognitive function of all subjects with Alzheimer disease(AD),frontotemporal dementia (FTLD),or mixed dementia (MD).Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of AD7c-NTP in urine.T&T test method was applied to detect the olfactory function.Spearman rank correlation was used to evaluate the correlation of urine AD7c NTP with MMSE and MoCA scores.Results There was no significant difference in the demographic profile (except age)among three types of dementia of AD,FTLD and MD(F =4.05,P =0.02).Among the three dementia groups,the mean age of the MD group was highest.The statistically significant difference in MMSE scores was found among the three groups(F 3.79,P=0.03),while there was no significant difference inMoCAand NPI scores among the three dementia groups.The levels of the urine AD7c-NTP were different among the three dementia groups,but without statistical significance(H 1.25,P =0.53).Additionally,the FTLD group had the highest urine AD7c NTP level.Spearman rank correlation analysis showed no correlation of AD7c-NTP with MMSE and MoCA(r =0.18,P =0.25;r =0.14,P =0.39,respectively).No differences in olfactory function of the recognition domain(H =3.40,P=0.18)and in the detection domain(H =2.07,P=0.36)were found among three dementia groups of AD,FTLD and MD.Conclusions The level of urine AD7c-NTP is not of clinical significance in differentiating three types of dementia,and it is not correlated with the MMSE and MoCA scores.This study fails to find the clinical value of olfactory function test for distinguishing three types of dementia.%目的 探讨不同类型痴呆患者阿尔茨海默病相关神经丝蛋白(AD7c-NTP)水平和嗅觉功能的差异,分析AD7c NTP水平和嗅觉功能测验在痴呆鉴别诊断中的应用价值. 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(MoCA)评价阿尔茨海默病(AD)34例、额颞叶痴呆(FTLD)29例和混合型痴呆(MD)14例患者认知功能.采用酶联免疫吸附试验检测尿液AD7c NTP表达变化,采用T&T嗅觉测试方法检测AD、FTLD、MD患者的嗅觉功能.采用Spearman秩相关分析评价AD、FTLD、MD患者尿液AD7c-NTP水平与MMSE和MoCA评分的相关性. 结果 AD、FTLD、MD患者的人口统计学资料除年龄(F=4.05,P=0.02)外均差异无统计学意义,三组患者中混合型痴呆的患者年龄最大.三组不同类型痴呆患者的神经心理学测验除MMSE评分(F=3.79,P=0.03)差异有统计学意义外,MoCA、神经精神问卷(NPI)评分无明显差异.AD、FTLD、MD患者尿液AD7c-NTP水平虽有差异,但差异无统计学意义(H=1.25,P=0.53),其中FTLD组尿液AD7c-NTP水平最高.Spearman秩相关分析显示AD7c-NTP与MMSE(r=0.18,P=0.25)、MoCA(r=0.14,P=0.39)评分均不相关.嗅觉功能的识别阈(H=3.40,P=0.18)和检知阈(H=2.07,P=0.36)在三种不同类型的痴呆患者中的差异均无统计学意义. 结论 尿液AD7c-NTP水平在AD、FTLD、MD的鉴别诊断中不具有临床实际意义,其与神经心理学测验MMSE、MoCA评分亦不具有相关性.该研究未能发现嗅觉功能检测在AD、FTLD、MD患者的鉴别中的临床应用价值.