血清SAA、sNFL水平对老年阿尔茨海默病的预测价值分析

Predictive values of serum SAA and sNFL levels in elderly Alzheimer’s disease

目的探讨血清淀粉样蛋白A(SAA)、血清神经丝蛋白轻链(sNFL)水平对老年阿尔茨海默病(AD)的预测价值。方法选取亳州市人民医院神经内科自2016年5月至2021年5月收治的147例具有AD危险因素的老年患者为研究组,另选取同期128例老年健康体检者(认知功能正常)为对照组,均行SAA、sNFL水平检测并对比。对研究组患者进行随访,观察其进展为AD的情况,并据此将其分为进展组与未进展组,对比SAA、sNFL水平,且采用受试者工作特征(ROC)曲线分析SAA、sNFL水平单项及联合对老年AD的预测价值。结果研究组SAA、sNFL水平高于对照组,差异具有统计学意义(P<0.05)。随访1~5(2.65±0.67)年,147例老年患者中进展为AD的有39例(进展组),进展率为26.53%。进展组SAA、sNFL水平均高于未进展组,差异具有统计学意义(P<0.05)。147例老年患者中5年后随访到8例,队列保持率为5.44%,其中随访5年进展为AD的有3例,未进展为AD的有5例。ROC结果显示,SAA、sNFL联合预测AD的灵敏度均高于单独预测(P<0.05),曲线下面积也高于单独预测(P<0.05),特异度与单独预测比较差异无统计学意义(P>0.05)。结论SAA、sNFL水平在AD患者中较非AD者升高,且均对AD具有一定预测价值,但二者联合预测价值更高。

Objective To investigate the predictive values of serum amyloid A(SAA)and serum neurofilament light chain(sNFL)levels in elderly patients with Alzheimer’s disease(AD).Methods One hundred and forty-seven elderly patients with AD risk factors treated in Neurology Department of Bozhou People’s Hospital from May 2016 to May 2021 were selected as the study group,and 128 elderly healthy persons(with normal cognitive function)in the same period were selected as the control group,and the levels of SAA and sNFL were detected and compared.The patients in the study group were followed up to observe their progress to AD,and they were divided into progressive group and non progressive group,and the levels of SAA and sNFL were compared,and the predictive values of SAA and sNFL levels on elderly AD were analyzed by receiver operating characteristic(ROC)curve.Results The levels of SAA and sNFL in the study group were higher than those in the control group(P<0.05).Follow up for 1-5(2.65±0.67)years,there were 39 cases of AD(progressive group)in 147 elderly patients,and the progress rate was 26.53%.The levels of SAA and sNFL in progressive group were higher than those in non progressive group(P<0.05).Of the 147 elderly patients,8 patients were followed up after 5 years,and the cohort retention rate was 5.44%,and 3 cases progressed to AD and 5 cases did not progressed to AD after 5 years of follow-up among them.ROC results showed that the sensitivity of SAA and sNFL in combination prediction of AD was higher than that of single prediction(P<0.05),and the area under the curve was also higher than that of single prediction(P<0.05),but there was no significant difference between specificity and single prediction(P>0.05).Conclusion The SAA and sNFL levels in AD patients are higher than those in non AD patients,and they all have certain predictive value for AD,but the combined predictive value is higher.