脑脊液tau蛋白和磷酸化tau蛋白测定在阿尔茨海默病诊断中的应用价值

Application of tau and Phosphorylated tau Protein Examinations in Diagnosis of Alzheimer's Disease

目的探讨脑脊液tau蛋白和磷酸化tau（p-tau）蛋白检测在阿尔茨海默病（AD）诊断中的应用价值。方法选取2012年4月~2014年4月在中国人民解放军第309医院和佳木斯大学附属医院接受治疗的AD患者（AD组）、血管性痴呆患者（VD组）及非神经系统疾病患者各50例为研究对象,检测并分析患者脑脊液tau蛋白和p-tau蛋白的含量。结果 AD组患者脑脊液p-tau蛋白含量为（190.3±83.1）pg/mL,显著高于VD组患者的（73.4±36.2）pg/mL和非神经系统疾病组的（55.4±35.2）pg/mL（P〈0.05）;VD组患者脑脊液中p-tau蛋白含量与非神经系统疾病组相比,差异有统计学意义（P〈0.05）。以tau蛋白含量≥370pg/mL为AD诊断标准时,灵敏度、特异度、检验可靠性和与VD患者鉴别率分别为89.6%、78.8%、82.4%和66.8%;以p-tau蛋白含量≥120pg/mL为AD诊断标准时,灵敏度、特异度、检验可靠性和与VD患者鉴别率分别为93.5%、89.9%、91.7%和82.6%。结论脑脊液p-tau蛋白可作为临床鉴别诊断AD患者的辅助指标。

Objective To evaluate the application of tau and phosphorylated tau（p-tau）protein detection from cerebrospinal fluid in diagnosis of Alzheimer＇s disease（AD）.Methods Between April 2012 and April 2014,patients were divided into AD,vascular dementia（VD）and non-neurological disease,with 50 cases in each group.Their tau and p-tau protein from cerebrospinal fluid were detected and analyzed contrastively.Results P-tau protein level in group AD was（190.3±83.1）pg/mL,which was significantly higher than those of group VD（73.4±36.2）pg/mL and no-neurological disease group（55.4±35.2）pg/mL,respectively（P〈0.05）;there was a significant difference in p-tau level between VD group and non-neurological group（P〈0.05）;with tau protein level≥370pg/mL as a standard for diagnosis of AD,the sensitivity,specificity,reliability and differentiation rate of AD from VD were 89.6%,78.8%,82.4%,66.8%,respectively;with p-tau level≥120pg/mL as a criteria for AD diagnosis,the sensitivity,specificity,reliability and differentiation rate of AD from VD were 93.5%,89.9%,91.7%,89.9%,respectively.Conclusion The increase of p-tau level in cerebrospinal fluid could be a reliable biomarker for diagnosis of Alzheimer＇s disease.