半胱氨酸蛋白酶抑制剂C水平与轻度认知障碍和阿尔茨海默病的相关性

发布时间：2019-03-16 06:47

【摘要】：目的观察血清和尿半胱氨酸蛋白酶抑制剂C(Cys C)水平与轻度认知障碍(MCI)和阿尔茨海默病(AD)的相关性,探讨Cys C在MCI和AD诊断中的价值。方法选取168例MCI患者、AD患者和认知正常的健康人为研究对象。通过量表初筛和临床评估,将研究对象分为3组:MCI组(56例)、AD组(42例)和健康人对照组(70例)。用免疫比浊法分别测定3组人群血清和尿CysC水平,分析血清和尿Cys C水平与认知功能损害之间的相关性。绘制ROC曲线,评价测定Cys C的诊断价值。结果 MCI和AD患者血清和尿Cys C水平均较健康人对照组高(P均0.05);MCI和AD患者MMSE和MoCA得分均与血清Cys C水平呈负相关(rMCI-MMSE=-0.493,rMCI-MoCA=-0.607,rAD-MMSE=-0.513,rAD-MoCA=-0.224,P均㩳0.05),与尿Cys C水平也呈负相关(rMCI-MMSE=-0.246,rMCI-MoCA=-0.252,rAD-MMSE=-0.233,rAD-MoCA=-0.304,P均0.05)。尿Cys C诊断MCI的ROC曲线下面积(AUCROC)为0.866(95%CI:0.786~0.946),其诊断临界值为22.81 mg/L时,敏感性为92%,特异性为75%,Youden指数为0.67,阳性预测值为85.7%,阴性预测值为85.2%。结论血清和尿Cys C水平升高与老年人MCI和AD的认知功能下降相关,尿Cys C是一种非入侵诊断MCI的辅助方法。
[Abstract]:Aim to investigate the relationship between serum and urine glutathione protease inhibitor (C (Cys C) levels and mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to evaluate the value of Cys C in the diagnosis of MCI and AD. Methods 168 MCI patients, AD patients and normal cognitive subjects were selected. The subjects were divided into three groups: MCI group (56), AD group, 42 cases) and healthy control group (70 cases). The levels of serum and urine CysC were measured by immunoturbidimetry, and the correlation between serum and urine CysC levels and cognitive impairment was analyzed. ROC curve was drawn to evaluate the diagnostic value of Cys C. Results the levels of serum and urine Cys C in patients with MCI and AD were higher than those in healthy controls (P0.05). MMSE and MoCA scores were negatively correlated with serum Cys C levels in patients with MCI and AD (rMCI-MMSE=-0.493,rMCI-MoCA=-0.607,rAD-MMSE=-0.513,rAD-MoCA=-0.224,P? 0. 05). There was also a negative correlation between the level of urinary Cys-C and urine rMCI-MMSE=-0.246,rMCI-MoCA=-0.252,rAD-MMSE=-0.233,rAD-MoCA=-0.304,P. When the area under ROC curve of urine Cys C was 0.866 (95%CI:0.786~0.946) and the critical value of diagnosis was 22.81 mg/L, the sensitivity, specificity and Youden index were 92%, 75% and 0.677, respectively. The positive predictive value was 85.7% and the negative predictive value was 85.2%. Conclusion the increase of serum and urine Cys-C levels is associated with decreased cognitive function of MCI and AD in the elderly. Urinary Cys-C is a non-invasive method for diagnosis of MCI.
【作者单位】：河北医科大学第一医院中心实验室;河北医科大学第一医院精神卫生科;河北省脑老化与认知神经科学实验室;
【基金】：河北省科技支撑计划(09276103D,122777160) 河北省卫生厅医学科学研究重点项目(20130575)
【分类号】：R749.16

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