阿尔茨海默病脑脊液磷酸化神经丝及双螺旋丝免疫活性

The immunoreactivities of phosphorylated neurofilament and paired helical filament in CSF of Alzheimers disease.

目的探讨阿尔茨海默病（Ａｌｚｈｅｉｍｅｒｓｄｉｓｅａｓｅ，ＡＤ）患者脑脊液（ＣＳＦ）磷酸化神经丝（ＰＮＦ）和双螺旋丝（ＰＨＦ）免疫活性的变化及临床意义。方法采用竞争抑制型ＥＬＩＳＡ检测ＡＤ的ＣＳＦ中ＰＮＦ和ＰＨＦ的免疫活性，并与对照组即多发梗死性痴呆（ＭＩＤ）、其他神经疾病（ＯＤＣ）、精神分裂症（ＳＣＨ）及正常人（ＮＣ）进行比较。结果ＡＤ组ＣＳＦ中ＰＮＦ活性与ＭＩＤ、ＮＣ、ＳＣＨ无显著性差异。ＡＤ组ＣＳＦ中ＰＨＦ活性高于各对照组，而其ＰＮＦ／ＰＨＦ比值低于各对照组，有显著性意义。ＰＨＦ值与对照组个体间重叠的４例ＡＤ中仅１例其ＰＮＦ／ＰＨＦ值与相应的ＭＩＤ有重叠。结论单纯测定ＣＳＦ中ＰＮＦ免疫活性对ＡＤ的鉴别诊断无意义，测定ＣＳＦ中ＰＨＦ活性与ＰＮＦ／ＰＨＦ比值相结合可提高ＡＤ的诊断正确率，有可能发展为有临床意义的实验室诊断试验。

Objective To explore the immunoreactivities of phosphorylated neurofilaments(PNF) and paired helical filaments(PHF) in CSF of Alzheimers disease(AD).Methods The PNF and PHF immunoreactivities in CSF of AD were masnured with a competitive ELISA.The multi infarct dementia(MID),other neurological diseases(ODC),schizophrenia(SCH),and normal control (NC) were served as control groups.Results There were no significant differences of PNF immunoreactivity in CSF among AD,MID,SCH and NC. The levels of PHF immunoreactivity in CSF were significantly higher in AD than in the control groups.The values of PNF/PHF ratio in CSF were significantly lower in AD than in the control groups.The overlaping of the PHF immunoreactivity value was found in 4 patients with AD and some cases of control groups,but only 1 of the AD and 1 of the controls had overlaping of PNF/PHF value.Conclusions Only detecting PNF immunoreactivity is not helpful, but combined detection of PHF immunoreactivity with PNF/PHF ratio in CSF,may by valuable for distinguish diagnosis of AD. The ratio of PNF/PHF in CSF may be used as a significant index for diagosis of AD.