阿尔茨海默病患者血清炎性因子与血凝指标的变化

Changes of serum inflammatory factors and coagulation indexes in patients with Alzheimer's disease

目的观察阿尔茨海默病(AD)患者血清炎性因子[C反应蛋白(CRP)、白细胞(WBC)]及血凝标志物[纤维蛋白原(Fib)、D-二聚体(D-D)、血小板(PLT)]的异常变化。方法收集2014年3月—2016年3月贵州医科大学第三附属医院神经内科和贵州医科大学附属医院神经内科住院的AD患者(AD组)28例、血管性痴呆患者(VD组)37例作为研究对象。另选择非痴呆对照人群30例为健康对照组,胶体金免疫沉析法检测(RP,Clauss法检测外周血液中Fib和D-D浓度。另外,同步检测3组WBC和PLT进行比较分析;将CRP与Fib或D-D进行单因素相关分析。结果 AD组患者CRP为(2.18±1.04)mg/L,显著低于健康对照组的(2.95±0.75)mg/L(q=3.250,P=0.002);VD组[(2.66±0.94)mg/L]与健康对照组比较差异无统计学意义(q=1.372,P=0.167);AD组WBC为(8.4±1.3)×109/L,VD组为(8.9±1.7)×10~9/L,对照组为(7.8±1.4)×10~9/L,3组比较差异均无统计学意义(P>0.05)。健康对照组Fib为(2.85±0.87)g/L,低于AD组的(3.82±1.22)g/L和VD组的(4.31±1.57)g/L(P<0.05);AD组、VD组D-D值与健康对照组比较,差异均无统计学意义(P>0.05)。AD组PLT为(226±47)×10~9/L,VD组为(230±56)×10~9/L,对照组为(221±62)×10~9/L,3组比较差异无统计学意义(P>0.05)。AD组中CRP与Fib呈负相关(r=-0.71,P=0.008),与D-D无明显相关性(r=0.13,P=0.394)。结论 AD患者外周血液中的炎性因子和凝血指标均有一定异常;AD患者血液中的炎性反应很可能与凝血功能异常有一定关系。

Objective To investigate the levels of serum inflammatory markers [C reactive protein （CRP）, white blood cell （WBC）] and relative factors [fibrinogen （Fib）, D dimer （D-D）, platelet （PLT）] in patients with Alzheimer＇s disease （ AD） .Methods Twenty-eight Alzheimer ’ s disease （ AD） cases and 37 vascular dementia （ VD） cases were collect-ed from Department of Neurology in the Third Affiliated Hospital of Guizhou Medical University and Affiliated Hospital in Guizhou Medical University from March 2014 to March 2016 .The peripheral blood token from 28 cases of AD patients , 37 ca-ses of vascular dementia （ VD） patients and 30 cases of healthy control were tested for C reactive protein （ CRP） , fibrin origi-nal （ Fib） and D dimer （ D-D） concentration by colloidal gold immune precipitation analysis , Clauss method and colloidal gold assay respectively.In addition, the total number of white blood cells （WBC） and platelet count （PC） were collected and ana-lyzed, and the single factor correlation analysis between CRP and Fib or D-D was performed.Results CRP in AD group was （2.18 ±1.04） mg/L, which was lower than that of control group （2.95 ±0.75） mg/L （ q =3.250, P =0.002）.There was no significant difference in CRP between VD group and control group （ q =1.372, P =0.167）.Fib in control group was （2.85 ±0.87）g/L,which was lower than the AD group （3.82 ±1.22） g/L （ t =3.504, P =0.009）, also lower than the VD group （4.31 ±1.57） g/L （ t =4.554, P =0.007）.Compared with the control group , the D-D value of AD group or VD group, the difference was not significant （ t =0.483, P =0.765;t =0.491, P =0.708）.In AD group, CRP was negatively correlated with FBG （ r =-0.71, P =0.008）, and there was no significant correlation between CRP and D-D （ r =0.13, P =0.394）.Conclusion Inflammatory factors and coagulation indexes in peripheral blood of patients with AD were abnormal .＆nbsp;Inflammatory reaction in blood of patients with AD may be related to abnormal coagulation function .