AD患者血清NPTX2、Netrin-4水平与认知障碍的关系

Serum NPTX2 and Netrin-4 levels in patients with Alzheimer's disease and their relationship with cognitive impairment

目的分析阿尔茨海默病(AD)患者血清神经元正五聚蛋白2(NPTX2)、轴突生长诱向因子4(Netrin-4)水平与认知障碍的关系。方法选取2021年11月至2022年11月首都医科大学附属北京天坛医院神经病学中心收治的85例存在认知障碍AD患者作为研究组,另外选取同期80例认知功能正常的健康体检者作为对照组。所有对象入院后检测血清NPTX2、Netrin-4水平,并进行各组比较。采用Pearson相关性分析血清NPTX2、Netrin-4水平与MMSE评分的关系,采用受试者工作特征曲线(ROC)分析血清NPTX2、Netrin-4对AD患者认知障碍的评估价值,采用多因素Logistic回归分析影响AD患者认知障碍的相关因素。结果研究组患者血清NPTX2、Netrin-4水平明显低于对照组(P<0.05)。Pearson相关分析显示,AD患者血清NPTX2、Netrin-4水平与MMSE评分均呈正相关(rNPTX2=0.485、rNetrin-4=0.425,均P<0.001)。ROC曲线结果显示:血清NPTX2评估AD患者认知障碍的曲线下面积为0.845,截断值为20.52,敏感度、特异度分别为92.94%、61.25%;Netrin-4评估AD患者认知障碍的曲线下面积为0.872,截断值为73.56ng·mL^(-1),敏感度、特异度分别为92.94%、67.50%;血清NPTX2联合Netrin-4评估AD患者认知障碍的曲线下面积为0.929,敏感度、特异度分别为85.88%、86.25%。多因素Logistic回归分析显示,血清NPTX2、Netrin-4、年龄均为影响AD患者认知障碍的相关因素(P<0.05)。结论AD患者血清NPTX2、Netrin-4水平均降低,并与患者认知障碍密切相关,可作为AD患者认知障碍的评估指标。

Objective To explore the serum levels of neuron positive pentamerin 2(NPTX2)and axon growth inducing factor 4(Netrin-4)in patients with Alzheimer's disease(AD)and their relationship with cognitive impairment.Methods 85 patients with AD with cognitive impairment admitted to department of cognitive disorders,Center of neurology,Beijing Tiantan Hospital,Capital Medical University from November 2021 to November 2022 were selected as the study group,and 80 healthy people with normal cognitive function were selected as the control group.The serum NPTX2 and Netrin-4 levels of all subjects were measured after admission and compared with each other.Pearson correlation was used to analyze the relationship between the levels of serum NPTX2 and Netrin-4 and MMSE score,and the evaluation value of serum NPTX2 and Netrin-4 on cognitive impairment in patients with AD was analyzed using ROC,and the related factors affecting cognitive impairment in patients with AD were explored by multivariate logistic regression.Results The serum NPTX2 and Netrin-4 levels in the study group were lower compared with the control group(P<0.05).Pearson correlation analysis showed that the serum NPTX2 and Netrin-4 levels in AD patients were positively correlated with MMSE scores(rNPTX2=0.485,rNetrin-4=0.425,"P<0.001).The results of ROC curve showed that the area under the curve of serum NPTX2 for evaluating cognitive impairment in patients with AD was 0.845,the cut-off value was 20.52,and the sensitivity and specificity were 92.94%and 61.25%respectively.The area under the curve of Netrin-4 assessed cognitive impairment in patients with AD as 0.872,the cut-off value was 73.56ng mL-l,and the sensitivity and specificity were 92.94%and 67.50%respectively.The area under the curve of serum NPTX2 combined with Netrin-4 to assess cognitive impairment in AD patients was 0.929,and the sensitivity and specificity were 85.88%and 86.25%respectively.The serum NPTX2,Netrin-4 and age were related factors affecting cognitive impairment in patients with AD(P<0.05).Conclusion The levels of NPTX2 and Netrin-4 in serum of patients with AD are both decreased,which are closely related to cognitive impairment of patients,and can be used as evaluation indexes of cognitive impairment of patients with AD.