阿尔茨海默病患者血清P-tau-181、8-OHdG、Lp-PLA2水平与认知功能的关系及其预测价值分析

Relationship between Serum P-tau-181, 8-OHdG, Lp-PLA2 Levels and Cognitive Function in Patients with Alzheimer’s Disease and its Predictive Value Analysis

目的:探讨阿尔茨海默病(AD)患者血清磷酸化Tau蛋白-181(P-tau-181)、8-羟基脱氧鸟苷酸(8-OHdG)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与认知功能的关系及其预测价值。方法:选择2018年1月~2019年12月我院收治的AD患者90例作为AD组,血管源性痴呆(VD)患者90例作为VD组,同期于我院进行体检的健康者90例作为对照组,比较各组血清P-tau-181、8-OHdG、Lp-PLA2水平、蒙特利尔认知评估量表(MoCA)、简易智力状态检查量表(MMSE)、临床痴呆评定量表(CDR)评分,比较不同认知功能障碍程度AD患者血清P-tau-181、8-OHdG、Lp-PLA2水平,并分析各指标的相关性,应用ROC曲线分析血清P-tau-181、8-OHdG、Lp-PLA2水平对AD的预测价值。结果:AD组血清P-tau-181、8-OHdG、Lp-PLA2水平显著高于VD组和对照组(P<0.05),VD组和对照组血清P-tau-181、8-OHdG、Lp-PLA2水平比较无统计学差异(P>0.05)。AD组、VD组MoCA、MMSE评分显著低于对照组,CDR评分显著高于对照组(P<0.05),AD组和VD组MoCA、MMSE和CDR评分比较无统计学差异(P>0.05)。随着AD患者认知功能的降低,患者血清P-tau-181、8-OHdG、Lp-PLA2水平逐渐升高(P<0.05)。Pearson相关性分析显示,AD患者血清P-tau-181、8-OHdG、Lp-PLA2与MoCA、MMSE评分呈负相关,与CDR评分呈正相关(P<0.05)。ROC曲线分析显示,P-tau-181、8-OHdG、Lp-PLA2诊断AD的敏感度分别为88.55%、89.34%、89.77%,特异度分别为81.94%、82.56%、85.67%。结论:AD患者血清P-tau-181、8-OHdG、Lp-PLA2水平异常升高,其水平可以反映患者认知功能障碍程度,对AD的早期诊断和防治具有一定价值。

Objective:To investigate the relationship between serum phosphorylated tau-181(P-tau-181),8-hydroxydeoxyguanosine(8-OHdG),lipoprotein associated phospholipase A2(Lp-PLA2)and cognitive function in patients with Alzheimer’s disease(AD)and its predictive value analysis.Methods:90 patients with AD who were admitted in our hospital from January 2018 to December 2019 were selected as AD group,90 cases of vascular dementia(VD)patients as VD group,90 healthy people who had physical examination in our hospital at the same time as the control group,the levels of serum P-tau-181,8-OHdG,Lp-PLA2,Montreal Cognitive Assessment Scale(MoCA),Mini-mental State Examination(MMSE)and clinical dementia rating scale(CDR)were compared in each group,the serum levels of P-tau-181,8-OHdG and Lp-PLA2 in AD patients with different degrees of cognitive impairment were compared,and the correlation of each index was analyzed,ROC curve was used to analyze the predictive value of serum P-tau-181,8-OHdG and Lp-PLA2 levels for AD.Results:The serum levels of P-tau-181,8-OHdG,Lp-PLA2 in AD group were significantly higher than those of VD group and control group(P<0.05),there was no statistical difference between VD group and control group in serum levels of P-tau-181,8-OHdG,Lp-PLA2(P>0.05).The scores of MOCA,MMSE in AD group and VD group were significantly lower than those of control group,CDR score was significantly higher than that of control group(P<0.05),there was no statistical difference in Moca,MMSE and CDR scores between AD group and VD group(P>0.05).With the decrease of cognitive function in AD patients,the serum levels of P-tau-181,8-OHdG,Lp-PLA2 gradually increased(P<0.05).Pearson correlation analysis showed that serum P-tau-181,8-OHdG,Lp-PLA2 were negatively correlated with MOCA,MMSE scores,and positively correlated with CDR scores(P<0.05).ROC curve analysis showed that the sensitivity of P-tau-181,8-OHdG,Lp-PLA2 in the diagnosis of AD was 88.55%,89.34%,89.77%,and the specificity was 81.94%,82.56%,85.67%.Conclusion:The serum levels of P-tau-181,8-OHdG,Lp-PLA2 in patients with AD are abnormally elevated,which can reflect the degree of cognitive dysfunction of patients,and have certain value for early diagnosis and differential diagnosis of AD.