尿阿尔茨海默病相关神经丝蛋白联合血浆同型半胱氨酸测定在阿尔茨海默病诊断中的研究

A study on measurement of Alzheimer-associated neuronal thread protein in urine combined with plasma homocysteine for diagnosing Alzheimer's disease

摘要:

目的 探讨尿阿尔茨海默病（AD）相关神经丝蛋白（AD7c-NTP）含量测定联合血浆同型半胱氨酸（Hcy）在AD诊断中的价值。方法 纳入轻度阿尔茨海默病（CDR=1分）及中重度阿尔茨海默病患（CDR ≥ 2分）者各40例，并选择健康体检志愿者40例为对照组，采用酶联免疫吸附测定法（ELISA）检测尿液中AD7c-NTP含量，采用循环酶法测定血浆Hcy的含量，通过绘制ROC曲线，分析二者联合检测对AD的诊断准确性。结果 3组受试者尿AD7c-NTP含量比较，差异有统计学意义（P<0.05）；组间比较差异均有统计学意义（P<0.05）。根据ROC曲线，当尿AD7c-NTP为1.745 ng/mL时，对应的灵敏度和特异度之和最大。3组受试者血浆Hcy的含量比较，差异有统计学意义（P<0.05）；组间比较差异均有统计学意义（P<0.01）。根据ROC曲线，当血浆HCY为15.05 μmol/L时，对应的灵敏度和特异度之和最大。当二者进行联合检测时，ROC曲线下面积为0.891，大于各项单独检测。结论 AD患者尿AD7c-NTP含量及血浆HCY含量均增高；尿液AD7c-NTP含量及血浆HCY含量可作为辅助AD诊断的生物标记物；二者联合检测可提高AD诊断的准确性。

Abstract:

Objective To explore the clinical significance of measuring the Alzheimer-associated neuronal thread protein (AD7c-NTP) in urine combined with plasma homocysteine (Hcy) for diagnosing Alzheimer's disease (AD).Methods A total of 40 cases of mild Alzheimer's disease (Clinical Dementia Rating[CDR]:1), 40 cases of moderate to severe Alzheimer's disease (CDR: ≥ 2), and 40 healthy volunteers in physical examination (control group) were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine the content of AD7c-NTP in urine. Enzymatic cycling assay was used to determine the content of plasma Hcy in the three groups. The receiver operating characteristic (ROC) curve was used to analyze the accuracy of the combined measurement of AD7c-NTP and Hcy for diagnosing AD.Results There was a significant difference in the content of AD7c-NTP in urine between the three groups (P<0.05). According to the ROC curve, the sum of sensitivity and specificity reached its maximum when the content of AD7c-NTP in urine was 1.745 ng/mL. There was a significant difference in the content of plasma Hcy between the three groups (P<0.05). According to the ROC curve, the sum of sensitivity and specificity reached its maximum when the content of plasma Hcy was 15.05 μmol/L. When a combined measurement of AD7c-NTP and Hcy was performed, the area under the ROC curve was 0.891, which was larger than that when AD7c-NTP or Hcy was measured alone.Conclusions The content of both AD7c-NTP in urine and plasma Hcy increases in patients with AD, so they may be used as biomarkers for the diagnosis of AD. In addition, a combined measurement of the two biomarkers could improve the accuracy of diagnosis of AD.