阿尔茨海默病及其前期患者尿AD7c-NTP与ApoE等位基因、认知功能的关系研究

Correlations of urinary Alzheimer-associated neuronal thread protein with apolipoprotein E allele and cognitive function in patients with subjective cognitive decline, mild cognitive impairment or Alzheimer's disease

目的探讨阿尔茨海默病(AD)及其前期患者尿阿尔茨海默病相关神经丝蛋白(AD7c-NTP)水平与载脂蛋白E(ApoE)等位基因、认知功能的关系。方法选择首都医科大学宣武医院神经内科自2019年1月至2021年1月收治的259例AD及其前期患者为研究对象,其中AD患者46例、轻度认知功能障碍(MCI)患者65例、主观认知功能下降(SCD)患者148例。所有患者均进行全套神经心理学量表测评、ApoE基因型及尿AD7c-NTP水平检测,应用Spearman秩相关检验分析患者尿AD7c-NTP水平与ApoE基因型等级、神经心理学量表测评结果的相关性。结果与MCI组和SCD组比较,AD组患者尿AD7c-NTP水平增高,差异有统计学意义(P<0.05)。ApoE基因型检测显示,259例患者中ApoE基因型1级24例、2级150例、3级10例、4级75例;与1级和2级比较,4级患者尿AD7c-NTP水平增高,差异有统计学意义(P<0.05)。相关性分析显示,患者尿AD7c-NTP水平与ApoE基因型等级呈正相关关系(r_(s)=0.264,P<0.001),与蒙特利尔认知评估量表、听觉词语学习测验-N5、动物词语流畅性测验、波士顿命名测验评分均呈负相关关系(P<0.05),与连线测验A、连线测验B评分均呈正相关关系(P<0.05)。结论AD及其前期患者尿AD7c-NTP水平越高,ApoE基因型等级越高,认知功能下降越重。

Objective To investigate the correlations of urinary Alzheimer-associated neuronal thread protein(AD7c-NTP)with apolipoprotein E(ApoE)allele and cognitive function in patients with subjective cognitive decline(SCD),mild cognitive impairment(MCI)and Alzheimer's disease(AD).Methods Two hundred and fifty-nine AD patients or patients at prodromal AD stage,including SCD(n=148),MCI(n=65),and AD(n=46),admitted to Department of Neurology,Xuanwu Hospital,Capital Medical University from January 2019 to January 2021,were chosen.Results of neuropsychological assessment,ApoE alleles and urinary AD7c-NTP level were collected in all subjects.Correlations of AD7c-NTP with grading of ApoE alleles and neuropsychological assessment results were analyzed by Spearman's rank correlation.Results Urinary AD7c-NTP level in AD group was significantly higher than that in MCI group and SCD group(P<0.05).ApoE genotype test showed that,in these 259 subjects,24 had ApoE genotype grading 1,150 had APOE genotype grading 2,10 had APOE genotype grading 3,and 75 had APOE genotype grading 4;compared with patients with ApoE genotype grading 1 and 2,patients with ApoE genotype grading 4 had significantly increased urinary AD7c-NTP level(P<0.05).Correlation analysis showed that urine AD7c-NTP level was positively correlated with ApoE genotype grading(r_(s)=0.264,P<0.001).Urinary AD7c-NTP level was negatively correlated with scores of Montreal cognitive assessment,auditory verbal learning test-N5,animal verbal fluency test and Boston naming test(P<0.05),and positively correlated with shape trails tests-A and shape trails tests-B scores(P<0.05).Conclusion In AD patients or patients at prodromal AD stage,the higher the urinary AD7c-NTP level,the higher the ApoE genotype grading and the greater the decline in cognitive function.