单核细胞趋化蛋白1、颗粒蛋白前体、胶质细胞源性神经营养因子水平与阿尔茨海默病认知功能、日常生活能力相关性分析

Study on serum MCP-1,PGRN and GDNF levels and diagnostic value in patients with Alzheimer's disease

目的 分析血清单核细胞趋化蛋白1(MCP-1)、颗粒蛋白前体(PGRN)、胶质细胞源性神经营养因子(GDNF)水平与阿尔茨海默病(AD)病人认知功能及日常生活能力的相关性,探讨其在AD中的诊断价值。方法 选取2019年7月至2021年6月入住苏州大学附属广济医院治疗的41例AD病人作为观察组,采用随机数字表法选取苏州大学附属广济医院同期经评估符合入组的41例健康志愿者作为对照组,运用酶联免疫吸附测定(ELISA)检测两组研究对象血清MCP-1、PGRN、GDNF水平;采用简易智力状态检查表(MMSE)及日常生活量表(ADL)评估其认知功能及日常生活能力。分析观察组病人血清MCP-1、PGRN、GDNF水平与MMSE、ADL评分的相关性;并通过受试者操作特征曲线(ROC曲线)分析MCP-1、PGRN、GDNF在AD中的诊断价值。结果 观察组MCP-1(321.7±51.1)ng/L、PGRN(42.6±8.5)μg/L水平较对照组MCP-1(242.6±35.2)ng/L、PGRN(26.5±6.1)μg/L显著增高,观察组GDNF(357.8±112.3)ng/L水平较对照组GDNF(468.0±106.6)ng/L显著降低,差异有统计学意义(P<0.05)。Pearson相关分析显示:观察组MMSE、ADL评分与血清MCP-1、PGRN水平均呈负相关(r=-0.46~-0.31,P<0.05),与PGRN水平呈正相关(r=0.47、0.46,P<0.05)。ROC曲线显示:MCP-1、PGRN、GDNF对AD的诊断价值较高,其ROC曲线下面积(AUC)分别为0.73、0.75、0.71,灵敏度分别为75.6%、75.6%、70.7%,特异度分别为61.0%、70.7%、63.4%,MCP-1、PGRN、GDNF三项标志物联合检测的AUC为0.83,灵敏度和特异度分别达到82.9%、75.6%。结论 AD病人血清MCP-1、PGRN水平表达明显增高,GDNF水平表达明显降低。这与AD病人认知功能和日常生活能力减退严重程度显著相关。三项指标联合检测在AD诊断中有着重要的参考价值.

Objective To analyze the correlation between serum monocyte chemoattractant protein-1(MCP-1),granule protein precursor(PGRN),glial cell-derived neurotrophic factor(GDNF) and cognitive function and activities of daily living in patients with Alzheimer's disease(AD),and to explore its diagnostic value in AD.Methods The 41 patients with AD admitted in Guangji Hospital affiliated to Soochow University from July 2019 to June 2021 were selected as the study group,and 41 healthy volunteers who met the evaluation in the same period were randomly selected as the control group.The levels of serum MCP-1,PGRN and GDNF were measured by enzyme-linked immunosorbent assay(ELISA);The mini mental state examination(MMSE) and daily living scale(ADL)were used to assess their cognitive function and daily living ability.The correlation between serum MCP-1,PGRN,GDNF levels and MMSE and ADL scores of the study group was analyzed.And through the receiver operating characteristic curve(ROC curve) to analyze the diagnostic value of MCP-1,PGRN,GDNF in AD.Results TThe levels of MCP-1(321.7±51.1) ng/L and PGRN(42.6±8.5) μg/L in the study group were significantly higher than those of the control group MCP-1(242.6±35.2) ng/L and PGRN(26.5±6.1) μg/L,The GDNF(357.8±112.3) ng/L level of the study group was significantly lower than that of the control group GDNF(468.0±106.6) ng/L,and the difference was statistically significant(P0.05).Pearson correlation analysis showed that MMSE and ADL scores were negatively correlated with serum MCP-1 and PGRN levels in the study group(r=-0.46--0.31,P0.05).It was positively correlated with the level of PGRN(r=0.47,0.46,P0.05).The ROC curve showed that MCP-1,PGRN and GDNF had high diagnostic value for AD.the area under the ROC curve(AUC) was 0.73,0.75,0.71 respectively,the sensitivity was 75.6%,75.6%,70.7% respectively,and the specificity was 61.0%,70.7%,63.4% respectively.The AUC of MCP-1,PGRN and GDNF was 0.83,and the sensitivity and specificity were 82.9%,75.6% respectively.Conclusions The expression of serum MCP-1 and PGRN in AD patients was significantly increased,The expression of PGRN decreased significantly.This was significantly correlated with the severity of cognitive function and activities of daily living in AD patients.The combined detection of three indexes has important reference value in the diagnosis of AD.