遗忘型与血管型MCI患者尿AD7c-NTP水平检测及临床价值

AD7c-NTP levels in urine and its clinical value in patients with amnestic and vascular mild cognitive impairment

目的:研究遗忘型轻度认知功能障碍(a MCI)与血管型轻度认知功能障碍(Va MCI)患者尿阿尔茨海默病相关神经丝蛋白(AD7c-NTP)水平及其临床价值。方法:选取轻度认知功能障碍(MCI)患者70例,其中a MCI组40例,Va MCI组30例,收集同期健康体检者27例为对照组,应用Mo CA量表进行认知功能评估,测定并比较各组的尿AD7c-NTP水平,并与认知水平进行相关性分析,通过ROC曲线分析其诊断a MCI的敏感度和特异性。结果:a MCI组的尿AD7c-NTP水平较Va MCI组和对照组明显升高(P<0.05);相关性分析显示尿AD7c-NTP水平与Mo CA评分呈负相关(r=-0.362,P<0.01);根据ROC曲线分析,确定2 507.10 ng/L为诊断a MCI的界定值,其对应的敏感性和特异性分别为80%和77.8%,ROC曲线下面积为0.828,95%CI:0.728~0.928。结论:尿AD7c-NTP水平变化对诊断MCI,尤其是a MCI具有一定的临床价值,并且与a MCI的严重程度的可能存在一定的相关性。

Objective:To analyze the value of Alzheimer-associated neuronal thread protein(AD7c-NTP)levels by measuring them in patients with amnestic mild cognitive impairment(aMCI)and vascular mild cognitive(VaMCI).Methods:Seventy patients with MCI and 27 health elderly persons in control group were selected.70 cases of MCI were divided into two groups:aMCI group(n=40)and VaMCI group(n=30).Montreal Cognitive Assessment(MoCA)was used to evaluate the cognition all the subjects.The urinary AD7c-NTP levels were measured and compared among the three groups.Then the differences of urinary AD7c-NTP levels were compared with the cognition level.And the diagnostic sensitivity and specificity of aMCI were analyzed by ROC curve analysis of urine AD7c-NTP level.Results:The urinary AD7c-NTP level was significantly higher in aMCI group than VaMCI group and control group(P<0.05).Correlation analysis showed that urinary AD7c-NTP levels were negatively correlated with MoCA scores(r=-0.362,P<0.01).Using receiver operating characteristic(ROC)curve,the optimal cutoff point of AD7c-NTP in urine for diagnosis of aMCI was 2507.10 ng/L,with 80%sensitivity and 77.8%specificity,the area under the curve was 0.828(95%CI:0.728~0.928).Conclusion:AD7c-NTP levels in the urine for the diagnosis of MCI,especially aMCI have some clinical value,and there may be some correlation between the severity of aMCI.