【摘要】：目的觀察血清和尿半胱氨酸蛋白酶抑制劑C(Cys C)水平與輕度認(rèn)知障礙(MCI)和阿爾茨海默病(AD)的相關(guān)性,探討Cys C在MCI和AD診斷中的價(jià)值。方法選取168例MCI患者、AD患者和認(rèn)知正常的健康人為研究對(duì)象。通過(guò)量表初篩和臨床評(píng)估,將研究對(duì)象分為3組:MCI組(56例)、AD組(42例)和健康人對(duì)照組(70例)。用免疫比濁法分別測(cè)定3組人群血清和尿CysC水平,分析血清和尿Cys C水平與認(rèn)知功能損害之間的相關(guān)性。繪制ROC曲線,評(píng)價(jià)測(cè)定Cys C的診斷價(jià)值。結(jié)果 MCI和AD患者血清和尿Cys C水平均較健康人對(duì)照組高(P均0.05);MCI和AD患者M(jìn)MSE和MoCA得分均與血清Cys C水平呈負(fù)相關(guān)(rMCI-MMSE=-0.493,rMCI-MoCA=-0.607,rAD-MMSE=-0.513,rAD-MoCA=-0.224,P均㩳0.05),與尿Cys C水平也呈負(fù)相關(guān)(rMCI-MMSE=-0.246,rMCI-MoCA=-0.252,rAD-MMSE=-0.233,rAD-MoCA=-0.304,P均0.05)。尿Cys C診斷MCI的ROC曲線下面積(AUCROC)為0.866(95%CI:0.786~0.946),其診斷臨界值為22.81 mg/L時(shí),敏感性為92%,特異性為75%,Youden指數(shù)為0.67,陽(yáng)性預(yù)測(cè)值為85.7%,陰性預(yù)測(cè)值為85.2%。結(jié)論血清和尿Cys C水平升高與老年人MCI和AD的認(rèn)知功能下降相關(guān),尿Cys C是一種非入侵診斷MCI的輔助方法。
[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.
【作者單位】： 河北醫(yī)科大學(xué)第一醫(yī)院中心實(shí)驗(yàn)室;河北醫(yī)科大學(xué)第一醫(yī)院精神衛(wèi)生科;河北省腦老化與認(rèn)知神經(jīng)科學(xué)實(shí)驗(yàn)室;
【基金】：河北省科技支撐計(jì)劃(09276103D,122777160) 河北省衛(wèi)生廳醫(yī)學(xué)科學(xué)研究重點(diǎn)項(xiàng)目(20130575)
【分類號(hào)】：R749.16

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