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血浆β-淀粉样蛋白40、42及磷酸化tau蛋白对 老年广泛性脑萎缩的诊断价值及与认知功能的 相关性
魏小莉曹江波
0
()
摘要:
目的 探讨血浆β-淀粉样蛋白40(Aβ40)、Aβ42 及磷酸化tau 蛋白(p-tau)对老年广泛性脑 萎缩(GBA)的诊断价值及与认知功能的相关性。方法 回顾性选取2018 年5 月至2019 年1 月湖北省荆 门市第二人民医院神经内科收治的125 例老年GBA 患者,根据是否合并认知功能障碍(CFI)分为GBACFI 组57 例与GBA-NCFI 组68 例,另选取130 名体检健康者为对照组,测定所有研究对象血浆Aβ40、 Aβ42 及p-tau 水平,根据简易智力状态检查量表(MMSE)将GBA-CFI 组分为重度CFI 组(≤ 9 分,n=14)、 中度CFI 组(10~20 分,n=19)、轻度CFI 组(≥ 21 分,n=24),分析血浆Aβ40、Aβ42 及p-tau 水平与老年 GBA 患者CFI 的关系及对老年GBA 合并CFI 的诊断价值。采用Pearson 相关分析Aβ40、Aβ42 与p-tau 水 平的相关性,采用多因素Logistic 回归分析老年GBA 患者CFI 的影响因素。采用受试者工作特征(ROC) 曲线分析Aβ40、Aβ42 及p-tau 水平对老年GBA 合并CFI 的诊断价值。结果 GBA-CFI 组血浆Aβ40、 Aβ42、p-tau 水平明显高于GBA-NCFI 组、对照组[分别为(910.33±275.76)μg/L 比(798.28±272.73)、 (667.10±240.63)μg/L,(89.81±18.32)μg/L 比(69.39±14.39)、(47.84±14.88)μg/L,(80.21±18.89)ng/L 比(58.84±16.20)、(21.52±10.53)ng/L;均P < 0.05],GBA-NCFI 组血浆Aβ40、Aβ42、p-tau 水平明显高 于对照组(均P<0.05)。GBA-CFI组CFI患者血浆Aβ40、Aβ42、p-tau水平随着CFI加重而提升[ 重 度、中度、轻度分别为:(1134.21±162.20)、(950.97±247.72)、(747.56±250.47)μg/L;(107.71±8.92)、 (95.79±12.28)、(74.62±13.73)μg/L;(104.71±8.21)、(84.52±5.07)、(62.51±10.14)ng/L;均P < 0.05]。 Pearson相关性分析显示,GBA-CFI组血浆Aβ40、Aβ42与p-tau水平呈正相关(r=0.715、0.655,均P<0.05)。 多因素Logistic回归分析结果显示,高水平Aβ4(0 OR=1.653,95%CI:1.186~2.302)、Aβ4(2 OR=1.064, 95%CI:1.027~1.103)、p-tau(OR=1.080,95%CI:1.040~1.121)为老年GBA 患者CFI 发生的危险因素(均 P < 0.05)。ROC 曲线分析结果显示,血浆Aβ40+Aβ42+p-tau 水平诊断老年GBA 的曲线下面积(AUC) 明显大于Aβ40、Aβ42、p-tau 单独诊断(均P< 0.05),敏感度、特异度、准确度也较Aβ40、Aβ42、p-tau 单 独诊断增加。结论 老年GBA 患者血浆Aβ40、Aβ42、p-tau水平明显提升,与CFI发生密切相关,联合 检测能提升老年GBA 诊断价值。
关键词:  老年  广泛性脑萎缩  认知功能  β-淀粉样蛋白40  β-淀粉样蛋白42  磷酸 化tau 蛋白
DOI:10.3969/j.issn.1009-6574.2021.01.006
基金项目:江苏省药学会奥赛康临床药学基金资助项目(A201735)
Diagnostic value of plasma Aβ40, Aβ42 and phosphorylated tau protein in the diagnosis of senilegeneralized brain atrophy and its correlation with cognitive function
Wei Xiaoli, Cao Jiangbo
()
Abstract:
Objective To investigate the diagnostic value of plasma amyloid β-protein 40( Aβ40), Aβ42 and phosphorylated tau protein( p-tau) in the diagnosis of senile generalized brain atrophy( GBA) and their correlation with cognitive function. Methods A total of 125 elderly GBA patients admitted to the Department of Neurology of Hubei Jingmen No. 2 People's Hospital, from May 2018 to January 2019, were retrospectively selected. The subjects were divided into GBA-CFI group with 57 cases and GBA-NCFI group with 68 cases according to whether combined with cognitive dysfunction( CFI). Another 130 healthy subjects were selected as the control group. The plasma Aβ40, Aβ42 and p-tau levels of all subjects were measured. According to the Mini Mental State Examination( MMSE) scale, the GBA-CFI group was classified as the severe CFI group( ≤9 points, n=14), moderate CFI group( 10~20 points, n=19) and mild CFI group( ≥21 points, n=24). The relationship between plasma Aβ40, Aβ42, p-tau levels and CFI in elderly patients with GBA and the diagnostic value of CFI in elderly patients with GBA was analyzed. Pearson correlation analysis was used to analyze the correlation between Aβ40, Aβ42 and p-tau levels. Multivariate logistic regression analysis was used to analyze the influencing factors of CFI in elderly patients with GBA. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of Aβ40, Aβ42 and p-tau levels in elderly GBA with CFI. Results The levels of plasma Aβ40, Aβ42, and p-tau in the GBA-CFI group were significantly higher than those in the GBA-NCFI group and control group, and the levels of plasma Aβ40, Aβ42, and p-tau in the GBANCFI group were significantly higher than those in the control group. The levels of Aβ40, Aβ42, and p-tau of the GAB-CFI group, GBA-NCFI group and the control group was( 910.33±275.76)μg/L vs( 798.28±272.73) vs (667.10±240.63)μg/L,( 89.81±18.32)μg/L vs( 69.39±14.39) vs( 47.84±14.88)μg/L,( 80.21±18.89)ng/L vs( 58.84±16.20) vs( 21.52±10.53)ng/L, respectively( all P <0.05). The levels of plasma Aβ40, Aβ42, and p-tau of patients in the GBA-CFI group increased with the aggravation of CFI. The levels of plasma Aβ40, Aβ42, and p-tau of the severe, moderate and mild CFI group were( 1134.21±162.20),( 950.97±247.72), (747.56±250.47)μg/L;( 107.71±8.92),( 95.79±12.28),( 74.62±13.73)μg/L;( 104.71±8.21), (84.52±5.07),( 62.51±10.14)( all P<0.05). Pearson correlation analysis showed that plasma Aβ40, Aβ42 were positively correlated with p-tau levels in the GBA-CFI group( r=0.715, 0.655, all P<0.05). Multivariate logistic regression analysis showed that Aβ40 (OR=1.653, 95%CI: 1.186-2.302), Aβ42 (OR=1.064, 95%CI: 1.027-1.103), p-tau( OR=1.080, 95%CI: 1.040-1.121) are risk factors for CFI in elderly GBA patients( all P< 0.05). ROC curve analysis showed that the area under the curve( AUC) of plasma Aβ40+Aβ42+p-tau level in the diagnosis of elderly GBA was significantly larger than that of Aβ40, Aβ42, and p-tau respectively( all P<0.05), and the sensitivity, specificity and accuracy were also higher than those of Aβ40, Aβ42, and p-tau respectively. Conclusions The levels of plasma Aβ40, Aβ42 and p-tau in elderly GBA patients are significantly increased, which are closely related to the occurrence of CFI. Combined detection can improve the diagnostic value of elderly GBA.
Key words:  Aged  Generalized brain atrophy  Cognitive function  Amyloid β-protein 40  Amyloid β-protein 42  Phosphorylated tau protein

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