特发性正常压力脑积水病人脑脊液标志物的变化

Changes of cerebrospinal fluid markers in patients with idiopathic normal pressure hydrocephalus

目的探讨特发性正常压力脑积水(iNPH)病人脑脊液(CSF)磷酸化tau蛋白(p-tau)、总tau蛋白(t-tau)、转化生长因子-β1(TGF-β1)的变化。方法前瞻性收集2018年6月至2020年2月经分流术临床确诊的16例iNPH为确诊组,同期行脑脊液释放试验无效的16例可疑iNPH为可疑组。采用酶联免疫吸附试验检测CSF中p-tau、t-tau、TGF-β1水平。结果确诊组CSF中p-tau水平显著低于可疑组(P<0.01),TGF-β1水平显著高于可疑组(P<0.01)。两组CSF中t-tau水平无统计学差异(P>0.05)。8例确诊iNPH术后7 d的CSF中p-tau、t-tau水平较术前均明显降低(P<0.05),而TGF-β1水平与术前无统计学差异(P>0.05)。结论本文结果提示CSF中p-tau、t-tau、TGF-β1在iNPH诊断、分流术效果评估中具有一定的作用。

Objective To investigate the changes of cerebrospinal fluid(CSF)markers including phosphorylated tau protein(ptau),total tau protein(t-tau),and transforming growth factorβ1(TGF-β1)in the patients with idiopathic normal pressure hydrocephalus(iNPH).Methods Sixteen patients with iNPH who were clinically diagnosed by shunt operation(observation group)and 16 patients who were suspected with iNPH and negative outcome of CSF tap test(control group)were prospectively recruited from June 2018 to February 2020.Enzyme-linked immunosorbent assay was used to detect the levels of CSF p-tau,t-tau and TGF-β1.Results The level of CSF ptau of the observation group was significantly lower than that of the control group(P<0.01),and the level of CSF TGF-β1 of the observation group was significantly higher than that of the control group(P<0.01).There was no statistical difference in the level of CSF t-tau between the two groups(P>0.05).The levels of CSF p-tau and t-tau of 8 patients in the observation group 7 days after the shunt operation were significantly lower than those before the operation(P<0.05),while the level of CSF TGF-β1 was not significantly different from that before the operation(P>0.05).Conclusions Our results suggest that the CSF p-tau,t-tau and TGF-β1 may be of certain value in the diagnosis and the outcome evaluation of shunt operation for the patients with iNPH.