中国临床心理学杂志

Alzheimer病与血管性痴呆患者脑脊液中β-淀粉样蛋白_1-42水平的对照研究

作者：李毅¹ 郝伟¹ 张中兴² 吕路线²

单位：1. 中南大学湘雅二医院湖南长沙 410011
2. 新乡医学院第二附属医院河南新乡 453002

分类号：R395.3

出版年,卷(期):页码：2004,12(3):269-271

摘要：

目的：探讨脑脊液(CSF)中β -淀粉样蛋白1-42(β -amyloidprotein1-42，Aβ1-42)的水平对Alzheimer病(AD)的诊断价值，寻找AD理想的生物学标志。方法：将符合美国国立神经病、语言障碍和卒中研究所 -老年性痴呆及相关性疾病协会(NINCDS -ADRDA)的”很可能AD”标准的22例AD患者，同时将20例血管性痴呆(vasculardementia，VD)和21例正常对照(normalcontrol,NC)纳入研究。用酶联免疫吸附法(ELISA)分别检测AD组、VD组和NC组CSF中的Aβ1-42 水平。同时评定：AD、VD组患者的简易智能量表(MMSE)、HACHINSKI缺血量表及临床痴呆量表(CDR)等参数。结果：三组CSF中Aβ1-42 平均浓度(x±s)(pg/ml)如下：AD组343.94±165.87;VD组 466.65±222 .46;NC组 480.40±217.16,AD组明显低于NC组(P <0.05) ;虽然AD组低于VD组、VD组低于NC组，但差异均无显著性(P >0.05) ;AD组CSF中Aβ1-42 浓度与CDR、MMSE评分明显相关(P <0.05)。结论：Alzheimer病患者CSF中Aβ1-42浓度降低是其重要的实验室表现，可以作为AD的辅助的诊断指标。

Objective:To investigate the cerebrospinal fluid(CSF)levels of β-amyloid peptide1-42(Aβ_1-42)in patients with Alzheimer' s disease(AD)and their diagnostic value for AD.Methods:The subjects were patients with AD and 41 controls,including 20 patients with vascular dementia(VD)and 21 normal controls(NC).The CSF levels of Aβ_1-42 of each subject were measured by enzyme-linked immunosorbent assay(ELISA).Subjects in the groups of both AD and VDwere assessed for parameters with MMSE, CDR and Hachinski rating scales.Results:(1)The mean CSF levels(pg/ ml)of Aβ_1-42 of AD grouPwas 343.94 ±165.87,VD 466.65±222.46,and NC 480.40±217.16.The CSF levels of Aβ_1-42 of AD group were significantly lower than that of NC(P<0.05).However,no significant difference was observed between other two groups(P>0.05).(2)In AD group, there were significant correlations between the CSF levels of Aβ_1-42and the MMSE or CDR scores(P<0.05).Conclusions: The CSF levels of Aβ_1-42 of patients with AD are significantly lower than that in NC group.Decreased CSF levels of Aβ_1-42 may be a marker for AD, which is helpful in diagnosing AD.

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参考文献：

[1] Blennow-K, Vanmechelen-E.Combination of the different biological markers for inceasing specificity of in vivo Alzhermer's testing.J-Neural-Transm-Suppl, 1998, 53:223-35
[2] Arai-H, Higuchi-S, Sasaki-H.Apolipoprotein E genotyping and cerebrospinal fluid tau protein: implications for the clinical diagnosis of Alzheimer's disease.Gerontology, 1997, 43 suppl 1: 2-10
[3] Green-AJ, Harvery-RJ, Thompson-EJ, et al.Increased tau in the cerebrospinal fluid of patiens with frontotemporal dementia and Alzheimer's disease .Neursci-Lett, 1999, 259(2): 133-135
[4] Nakaumra T, Shoji M, Harigaya Y, et al.Amyloid beta protein levels in cerebrospinal fluid are elevated in early-onset Alzheimer's disease.Ann Neurol, 1994, 36 (6): 903-911
[5] Chartier-Harlin MC, Crawford F, Houlden H, et al.An early-onset Alzheimer's disease caused by mutations at codon 717 of the beta-amyloid precursor protein gene.Nature, 1991, 353: 384-385
[6] Andreasen N, Hesse C, Davidsson P, et al.Cerebrospinal fluidβ-amyloid(1-42) in Alzheimer's disease differences between early and late-onset Alzheimer's disease and stability during the course of disease.Arch Neurol, 1999, 56(6): 673-680
[7] Brion-JP.The role of neurofibrillary tangles in Alzheimer disease.Acta-Neurol-Belg, 1998, 98(2): 165-174
[8] Anderton-BH, Dayanandan-R, Killick-R, et al.Does dysregulation of the Notch and wingless/Wnt pathways underlie the pathogenesis of Alzheimer's disease.Mol-Med-Today, 2000, 6(2): 54-59
[9] Motter R, Vigo Pelfrey C, Kholodenko D, et al.Reduction of beta-amyloid peptide 42 in the cerebrospinal fluid of patients with Alzheimer's disease.Ann Neurol, 1995, 38: 643-648
[10] Kanai M, Matsubara E, Isoe K, et al.Longitudinal study of cerebrospinal fluid levels of tau, Aβ1-40 and Aβ1-42(43) in Alzheimer's Disease: A study in Japan.Ann Neurol, 1998, 44: 17-26
[11] Andreasen N, Hesse C, Davidsson P, et al.Cerebrospinal fluidβ-amyloid(1-42) in Alzheimer's disease differences between early and late-onset Alzheimer's disease and stability during the course of disease.Arch Neurol, 1999, 56(6): 673-680

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