APOE ε4等位基因与尿AD7c-NTP联合检测在AD早期诊断中的初步研究

Combined detection of Apolipoprotein E ε4 allele and urinary AD7c-NTP in the early diagnosis of Alzheimer's disease

目的探讨APOEε4等位基因与尿AD7c-NTP联合检测在阿尔兹海默病(AD)早期诊断预防中的价值。方法根据中国精神障碍分类与诊断标准第三版(CCMD-3)有关精神分裂症及轻度阿尔兹海默病的诊断标准,选取76例临床诊断疑似AD患者(PAD组),另选90例健康者作为对照组。对比两组APOEε4等位基因频率和尿AD7c-NTP含量对AD的诊断价值。结果 (1)APOEε4等位基因表达频率在PAD组显著高于对照组(P≤0.05);(2)尿AD7c-NTP在PAD组中的含量较对照组显著升高(P≤0.01);(3)对APOEε4、AD7c-NTP及二者联合检测进行比较发现,APOEε4对AD诊断的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为:44.64%、88.33%、78.13%、63.10%、0.33;尿AD7c-NTP诊断的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为:78.57%、83.33%、81.48、80.65%、0.62;APOEε4与AD7c-NTP联合检测的诊断灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为:91.18%、91.55%、83.78%、95.58%、0.82。结论 APOEε4等位基因与尿AD7c-NTP联合检测是监测及诊断AD早期病变的较好指标,提升二者单独应用时的预测价值,宜作为AD易发人群鉴别和早期诊断的生物标记物。

Objective To investigate the early diagnosis significance of the combination detection of urinary AD7c- NTP and apolipoprotein E ε4 allele（ APOE ε4）for alzheimer＇ s disease. Methods According to the Standard of ＂Chinese classification and diagnostic criteria of mental disorders Third Edition （ CCMD-3 ） diagnostic criteria for schizophrenia and Alzheimer＇ s disease＂, 76 patients were grouped as probable AD group （PAD） , Additionally ,90 healthy individuals were in- cluded as control group. Then we analyzed and compared with the diagnostic value to two groups of the significance of the frequency of APOE ε4 allele and the mean urinary ADTc-NTP assay values. Results （ 1 ） The frequency of APOE ε4 al- lele was significantly increased in PAD individuals as compared to normal subjects （ P ≤ 0.05 ） ; （ 2 ） The mean urinary ADTc-NTP assay values were significantly higher in PAD subjects compared to normal individuals （ P ≤ 0.01 ） ; （ 3 ） Com- pared with APOE ε4, AD7e-NTP and combinatorial detection, the sensitivity, specificity, positive predictive value, negative predictive value and youden＇ s index of APOE ε4 allele detection for AD were 44.64% ,88.33% ,78. 13% ,63.10% , 0.33 ,respectively. The sensitivity,specificity,positive predictive value,negative predictive value and youden＇ s index of u- rinary AD7c-NTP detection for AD were 78.57% ,83.33% ,81.48,80.65% ,0.62, respectively. When we paralleled con- nection of two detection methods for the early diagnosis of AD, the sensitivity, specificity, positive predictive value, negative predictive value and youden＇ s index were as follow ：91.18% ,91.55% ,83.78% ,95.58% ,0.82. Conclusion The combi- nation detection of APOE ε4 and urinary AD7c-NTP is reliable biomarkers for the early diagnosis of alzheimer＇ s disease, the predictive value is significantly increased compared to either detection alone, suggesting that combinatorial detection might be a potential tool for the earlier identification and diagnosis of AD.