不同类型认知障碍的尿液AD7c-NTP与MRI、MRS的相关性研究

Urinary AD7c-NTP Levels on Different Types of Cognitive Disorders and its Relationship with MRI and MRS

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DOI
刊名
Journal of International Psychiatry
年,卷(期) 2017, 44(4)
作者
作者单位

中山大学附属第八医院 ;
中山大学附属第一医院康复医学科 ;
中山大学附属第八医院神经外科 ;
中山大学附属第八医院 ;

摘要
[摘要] 对不同类型认知障碍的尿液AD相关神经丝蛋白(AD7c-NTP)水平与头颅MRI中海马萎缩程度、MRS中N-乙酰天门冬氨酸(NAA)峰值水平的相互关系进行研究,探讨三者的检测在不同类型的认知障碍中的鉴别诊断意义。方法 选取2015年7月—2017年2月中山大学附属第八医院阿尔兹海默病(AD)、血管性痴呆(VaD)、轻度认知障碍(MCI)患者各30例,分别设为AD组、VaD组、MCI组,另选取同期体检健康者30例设为对照组。取所有受检者晨起时尿液,采用酶联免疫吸附法测定AD7c-NTP水平,并实施头颅MRI及MRS检查。统计对比四组尿液AD7c-NTP水平、海马萎缩MTA评分、NAA峰值水平,分析尿液AD7c-NTP水平与海马萎缩MTA评分、NAA峰值水平相关性。结果 (1)尿液AD7c-NTP水平:MCI组尿液AD7c-NTP水平高于对照组,VaD组尿液AD7c-NTP水平高于MCI组,AD组尿液AD7c-NTP水平高于VaD组,差异有统计学意义(P<0.05);(2)海马萎缩MTA评分:MCI组海马萎缩MTA评分与对照组比较,差异无统计学意义(P>0.05),VaD组海马萎缩MTA评分高于MCI组,AD组海马萎缩MTA评分高于VaD组,差异有统计学意义(P<0.05);(3)NAA峰值水平:MCI组NAA峰值水平与对照组比较,差异无统计学意义(P>0.05),VaD组NAA峰值水平低于MCI组,AD组NAA峰值水平低于VaD组,差异有统计学意义(P<0.05);(4)尿液AD7c-NTP水平与海马萎缩MTA评分、NAA峰值水平相关性:尿液AD7c-NTP水平变化与海马萎缩MTA评分呈正相关关系(r1=0.336,r2=0.329,P<0.05);与NAA峰值水平呈负相关关系。结论 AD、VaD、MCI患者尿液AD7c-NTP水平较高,且不同类型认知障碍患者尿液AD7c-NTP、海马萎缩MTA评分、NAA峰值水平存在明显差异,尿液AD7c-NTP水平变化与MRI改变呈正相关性,与MRS改变呈负相关性,可将其用于认知障碍类型的鉴别诊断,在临床工作中具有可操作性,值得推广。
Abstract
[Abstract] Objective To investigate the urinary AD-related neurofilament protein (AD7c-NTP) on different types of cognitive disorders and its relationship with the degree of hippocampus atrophy in head MRI and MRS N - acetyl - aspartate (NAA) peak level, and to explore the differential diagnosis of the three different detection in different types of cognitive impairment. Methods From July 2015 to February 2017, Alzheimers disease (AD), vascular dementia (VaD) and mild cognitive impairment (MCI) (each 30 cases) in the Eighth Hospital Affiliated to Sun Yat - sen University were divided into AD group, VaD group and MCI group, another 30 healthy subjects were selected as control group. Took urine samples from all the subjects in the morning and AD7c-NTP levels were measured by enzyme-linked immunosorbent assay, besides, head skull MRI and MRS examination were performed as well. AD7c-NTP, hippocampal atrophy MTA score, NAA peak level were statistically compared in the four groups, and correlation of urinary AD7c-NTP level with hippocampus atrophy MTA score and NAA peak level was analyzed. Results (1)The urinary AD7c-NTP level: Urinary AD7c-NTP level in MCI group was higher than that in control group, urine AD7c-NTP level in VaD group was higher than that in MCI group, and AD7c-NTP level in AD group was higher than that in VaD group, the difference was statistically significant (P<0.05); (2) Hippocampus atrophy MTA score : There was no significant difference in the MTA score between the MCI group and the control group (P>0.05), the VaD group was higher than that in MCI group, the AD group was higher than that in VaD group and the difference was statistically significant (P<0.05); (3) NAA peak level: There was no significant difference in NAA peak level between MCI group and control group (P>0.05), the VaD group was lower than that in MCI group, while the AD group was lower than that in VaD group (P<0.05); (4) The correlation of urinary AD7c-NTP levels with hippocampus atrophy MTA score and peak NAA level: there was a positive correlation between AD7c-NTP level and hippocampal atrophy MTA score (r1 = 0.336, r2 = 0.329, P<0.05); and it was negatively correlated with NAA peak level. Conclusion Urinary AD7c-NTP level in AD, VaD and MCI group is higher, and there are significant differences in urinary AD7c-NTP level, hippocampal atrophy MTA score and NAA peak level in different types of cognitive disorders, urine AD7c-NTP level changes were positive correlate with MRI, and it was negatively correlated with MRS, which can be used for the differential diagnosis of cognitive disorders.
关键词
[关键词] 尿液AD7c-NTP;不同类型认知障碍;MRI;MRS;海马萎缩MTA评分;NAA峰值水平。
KeyWord
[Keywords] Urine AD7c-NTP; Different types of cognitive disorders; MRI; MRS; Hippocampus atrophy MTA score; NAA peak level.
基金项目
页码 643-645
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李爱东,陈曦*,陈建良,何苏云,陈琦,蔡思敏. 不同类型认知障碍的尿液AD7c-NTP与MRI、MRS的相关性研究 [J]. 国际精神病学杂志. 2017; 44; (4). 643 - 645.

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