Alzheimer病早期脑脊液tau蛋白与ApoE基因的关系

The relation between cerebrospinal fluid tau and apolipoprotein E gene in early Alzheimer′s disease

目的探讨Alzheimer病患者脑脊液tau蛋白与ApoE基因型的关系。方法对84例患者脑脊液微管相关蛋白(tau蛋白)应用ELISA法对进行定量,其中41例临床诊断为早期Alzheimer病(AD),23例伴其他类型的痴呆,6例为Down综合征患者;14例非痴呆患者为对照组。结果多变量ANOVA分析显示痴呆患者与ApoE等位基因者脑脊液tau蛋白升高,AD患者脑脊液tau蛋白浓度明显高于对照组。而非AD痴呆患者脑脊液tau蛋白浓度与AD患者和对照组无明显差异,伴ApoEε4等位基因的AD病人与不伴ε4等位基因的AD病人相比,tau蛋白浓度升高。结论脑脊液tau蛋白浓度升高提示携带ε4等位基因AD病人早期发生神经变性和神经纤维病理学改变,应用ELISA法检测脑脊液tau蛋白对诊断早期AD及与其他类型的痴呆相鉴别缺乏敏感性和特异性,应首先考虑ApoE基因类型。

Objective To study the relation between cerebrospinal fluid tau and apolipoprotein E genotype. Methods ELISA assay was used to measure CSF tau in 84 subjects： 41 patients with clinically diagnosed early Atzheimer＇ s disease（AD）, 23 patients with other dementia,6 cases were Down＇s syndrome patients, and 14 cases were nondemented neurologic control subjects. Results Multivariate ANOVA analysis showed that CSF tau increased in dementia patients and apolipoprotein E allele. However, CSF tau in non-AD dementia group did not differ significantly from AD patients or control subjects. Tau levels were increased in AD patients with apolipoprotein E ε4 allale more than without ε4 allale patients. Conclusion CSF tau levels increased may indicate pronounced neuronal degeneration and neurofibrillar pathology in the early of AD patients with ε4 allale. ELISA test for CSF tau is not sensitive and specific in diagnosis of early AD and distinguish from other dementia, the ApoE genotype should be to think over.