脑脊液神经蛋白质对临床拟诊Creutzfeldt—Jakob病的早期诊断价值

The early diagnostic value of neuroproteins in the cerebrospinal fluid for possible Creutzfeidt-Jakob disease

目的探讨和比较数种神经蛋白质对 Creutzfeldt-Jakob 病(CJD)的早期诊断价值。方法对14例发病2个月内 CJD 取脑脊液,采用蛋白捕捉法和酶联免疫试验对总 tau 蛋白(t-tau)、磷酸化 tau 蛋白(p-tau)、t-tau 蛋白与 p-tau 蛋白比值(t-tau/p-tau)、S-100β蛋白、14-3-3蛋白及14-3-2蛋白进行定量检测,同时设非 CJD 痴呆(OD,11例)和无痴呆(ND,18例)的对照组。结果 (1)t-tau蛋白:CJD 组、OD 组和 ND 组分别是8295、300、161 pg/ml。p-tau/t-tau 值分别是0.0092、0.2258、0.2471。(2)S-100β蛋白:CJD 组、OD 组、ND 组分别是1.576、0.639、0.239 ng/ml。(3)14-3-3蛋白:CJD 组、OD 组、ND 组分别是40.00、2.65、3.10 ng/ml。(4)14-3-2蛋白:CJD 组、OD 组与 ND 组分别是48.43、14.00、20.50 ng/ml。(5)t-tau≥500 pg/ml 为阈值点,敏感度为84.6%,特异度87.5%,p-tau 无诊断意义;(6)S-100B 蛋白≥1.626 ng/ml 为阈值点,敏感度为92.3%,特异度为83.8%;(7)14-3-3蛋白以≥9 ng/ml 为阈值点,敏感度为86.7%,特异度为86.4%;(8)14-3-2蛋白以≥24 ng/ml 为阈值点,其敏感度为78.6%,特异度为77.3%。结论脑脊液神经蛋白质检测对散发性 Creutzfeldt-Jakob病的早期诊断有一定价值。

Objective To inquire and compare the value of 4 proteins in the cerebrospinal fluid （CSF） for early diagnosis of Creutzfeldt-Jakob disease （CJD）. Methods The CSF samples were obtained from 14 CJD patients in the early stage, t-tan, p-tan, t-tau/p-tau, S-100β, 14-3-3 and 14-3-2 protein had been examined and compared with other dementia （OD） and none dementia （ND） as controls by capture assay and ELISA. Results （ 1 ） t-tau protein： the concentration in CJD , OD and ND is 8295, 300 and 161 pg/ml respectively, p-tau/t-tau ratio is 0. 0092,0. 2258 and 0. 2471 respectively. （2） S-100β protein： the concentration in CJD, OD and ND is 1. 576, 0. 639 and 0. 239 ng/ml respectively. （3） 14-3-3 protein ： the concentration in CJD,OD and ND is 40. 00,2. 65 and 3.10 ng/ml respectively. （4） 14-3-2 protein： the concentration in CJD, OD and ND is 48. 43,14. 00 and 20. 50 ng/ml respectively. （5） At the cut-off point 500 pg/ml for t-tan, sensitivity for diagnosis of CJD is 84.6% and specificity is 87.6%, p-tau has no diagnostic value to CJD, （ 6 ） At 1. 626 ng/ml for S-100β, the sensitivity is 92. 3% and specificity is 83.8%. （7） At 9 ng/ml for 14-3-3 protein,the sensitivity is 86. 7% and specificity is 86.4%. （8） At a level of 24 ng/ml for 14-3-2 protein, the sensitivity for diagnosis of CJD is 78.6% and specificity is 77. 3%. Conclusion It is the CSF detection of neuroproteins that have great valuble significance in diagnosis for sporadic CJD in the early stage.