阿尔茨海默病患者脑脊液p-Tau及α-突触核蛋白的表达及意义

Expression of p-Tau andα-synuclein in Alzheimer’s disease cerebrospinal fluid and its correlation with the degree of the disease

目的探讨磷酸化牛磺酸(p-Tau)、α-突触核蛋白在阿尔茨海默病(AD)患者脑脊液中表达的意义,分析其与AD病情程度的相关性。方法选取2015-01—2019-08郑州市第一人民医院收治的149例AD患者,采用简易精神状态量表(MMSE)评估AD病情严重程度,根据MMSE评分分为轻中度组和重度组。比较2组脑脊液p-Tau、α-突触核蛋白表达水平,对比可能导致AD病情加重的相关因素,采用Logistic回归分析导致AD病情加重的危险因素,采用Pearson相关系数法分析脑脊液p-Tau、α-突触核蛋白水平与MMSE评分的相关性。结果重度组MMSE评分显著低于轻中度组,脑脊液p-Tau、α-突触核蛋白表达水平显著高于轻中度组,差异有统计学意义(P<0.05)。经Logistic回归分析高血压(OR=2.077,95%CI:1.785~2.369,P<0.001)、糖尿病(OR=3.323,95%CI:2.878~3.769,P<0.001)、痴呆家族史(OR=2.499,95%CI:1.748~3.251,P=0.002)、脑脊液p-Tau(OR=2.389,95%CI:1.236~3.543,P=0.002)、α-突触核蛋白(OR=2.492,95%CI:2.197~2.787,P=0.001)均是导致重度AD的危险因素。Pearson相关性分析示AD患者脑脊液中p-Tau蛋白水平与MMSE评分呈负相关(r=-0.816,P<0.001),α-突触核蛋白浓度与MMSE评分呈负相关(r=-0.735,P<0.001)。结论脑脊液p-Tau、α-突触核蛋白是导致重度AD的危险因素,两者表达水平随AD患者病情严重程度增加而升高,与MMSE评分呈负相关。

Objective To explore the significance of phosphorylated taurine(p-Tau)andα-synuclein expression in the cerebrospinal fluid of patients with Alzheimer’s disease(AD),and to analyze their correlation with the degree of AD.Methods A total of 149 AD patients admitted to our hospital from January 2015 to August 2019 were selected,and the severity of AD was assessed by the mini mental state examination(MMSE)scale.The patients were divided into mild-moderate group and severe group according to MMSE scores.Compared the expression levels of p-Tau andα-synuclein in the cerebrospinal fluid of the patients in two groups,and compared the differences in the relevant factors that may cause the aggravation of AD.Logistic regression analysis was used to analyze the risk factors of the aggravation of AD.Pearson correlation coefficient method was used to analyze the correlation between the levels of p-Tau andα-synuclein in cerebrospinal fluid and MMSE scores.Results The MMSE scores of the severe group were significantly lower than that of the mild-moderate group,and the expression levels of cerebrospinal fluid p-Tau andα-synuclein were significantly higher than that of the mild-moderate group,the difference were statistically significant(P<0.05).Logistic regression analysis showed hypertension(OR=2.077,95%CI:1.785-2.369,P<0.001),diabetes(OR=3.323,95%CI:2.878-3.769,P<0.001),family history of dementia(OR=2.499,95%CI:1.748-3.251,P=0.002),cerebrospinal fluid p-Tau(OR=2.389,95%CI:1.236-3.543,P=0.002),α-synuclein(OR=2.492,95%CI:2.197-2.787,P=0.001)are all risk factors for severe AD.Pearson correlation analysis showed that the level of p-Tau protein in cerebrospinal fluid of AD patients was negatively correlated with MMSE scores(r=-0.816,P<0.001),α-synuclein concentration was negatively correlated with MMSE scores(r=-0.735,P<0.001).Conclusion p-Tau andα-synuclein in cerebrospinal fluid are risk factors for severe AD.The expression levels of the two increase with the severity of AD patients,which are negatively correlated with MMSE score.