轻度认知障碍和主观认知功能下降患者血清β-淀粉样蛋白、磷酸化Tau蛋白水平及其与认知功能的关系研究

Serum Amyloid β-Protein and Phosphorylated Tau Protein Levels in Patients with Mild Cognitive Impairment and Subjective Cognitive Decline and Their Correlation with Cognitive Function

目的探讨轻度认知障碍(MCI)和主观认知功能下降(SCD)患者血清β-淀粉样蛋白(Aβ)、磷酸化Tau蛋白水平及其与认知功能的相关性。方法选取2019年6月至2022年12月南京医科大学第一附属医院康复医学中心收治的MCI患者62例为MCI组,SCD患者99例为SCD组,认知功能正常(NC)者44例为对照组。采用酶联免疫吸附试验检测血清Aβ1-42、磷酸化tau-181蛋白(p-Tau-181)水平。采用简易精神状态检查量表(MMSE)和蒙特利尔认知评估量表(MoCA)评价受试者整体认知功能,采用华山版听觉词语学习测验(AVLT-H)中的延迟记忆(N5)、再认(N7)维度评价受试者记忆功能,采用连线测试(TMT)-A和TMT-B评价受试者执行功能,采用波士顿命名测试(BNT)和动物流畅性测验(AFT)评价受试者言语功能。比较三组血清Aβ1-42、p-Tau-181水平及认知功能量表评分,血清Aβ1-42、p-Tau-181水平及认知功能量表评分间的相关性分析采用Spearman秩相关分析。结果SCD组血清Aβ1-42、p-Tau-181水平高于对照组,MoCA评分低于对照组,TMT-A、TMT-B结果长于对照组,AFT结果少于对照组(P<0.05);MCI组血清Aβ1-42、p-Tau-181水平高于对照组,MMSE评分、MoCA评分、N5维度评分、N7维度评分低于对照组,TMT-A、TMT-B结果长于对照组,BNT、AFT结果少于对照组(P<0.05);MCI组MMSE评分、MoCA评分、N5维度评分、N7维度评分低于SCD组,TMT-A、TMT-B结果长于SCD组,BNT、AFT结果少于SCD组(P<0.05)。Spearman秩相关分析结果显示,血清Aβ1-42水平与血清p-Tau-181水平呈正相关,与MMSE评分、MoCA评分、N7维度评分、AFT结果呈负相关(P<0.05);血清p-Tau-181水平与MMSE评分、MoCA评分、AFT结果呈负相关(P<0.05)。结论MCI及SCD患者血清Aβ1-42、p-Tau-181水平高于NC者,血清Aβ1-42、p-Tau-181水平与整体认知功能、言语功能呈负相关,可考虑作为诊断认知障碍的辅助指标。

Objective To investigate the serum amyloidβ-protein(Aβ)and phosphorylated Tau protein levels in patients with mild cognitive impairment(MCI)and subjective cognitive decline(SCD)and their correlation with cognitive function.Methods A total of 62 patients with MCI admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Nanjing Medical University from June 2019 to December 2022 were selected as the MCI group,99 patients with SCD were selected as the SCD group,and 44 patients with normal cognition(NC)were selected as the control group.Serum Aβ1-42 and p-Tau-181 levels were detected by enzyme linked immunosorbent assay.Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)were used to evaluate the global cognition function,the delayed memory(N5)and recognition(N7)dimension in the Auditory Verbal Learning Test-Huashan Version(AVLT-H)were used to evaluate the memory function,Trail Making Test(TMT)-A and TMT-B were used to evaluate the executive function,and Boston Naming Test(BNT)and Animal Fluency Test(AFT)were used to evaluate the language function.Serum Aβ1-42 and p-Tau-181 levels and scores of cognition function scales were compared among the three groups,and the correlations between serum Aβ1-42 and p-Tau-181 levels and scores of cognition function scales were analyzed by Spearman rank correlation analysis.Results Serum Aβ1-42 and p-Tau-181 levels in the SCD group were higher than those in the control group,the MoCA score was lower than that in the control group,TMT-A and TMT-B results were longer than those in the control group,and AFT results was lower than that in the control group(P<0.05).Serum Aβ1-42 and p-Tau-181 levels in the MCI group were higher than those in the control group,MMSE score,MoCA score,N5 dimension score and N7 dimension score were lower than those in the control group,TMT-A and TMT-B results were longer than those in the control group,BNT and AFT results were less than those in the control group(P<0.05).The MMSE score,MoCA score,N5 dimension score,and N7 dimension score in the MCI group were lower than those in the SCD group,TMT-A and TMT-B results were longer than those in the SCD group,and BNT and AFT results were less than those in the SCD group(P<0.05).The results of Spearman rank correlation analysis showed that serum Aβ1-42 level was positively correlated with serum p-Tau-181 level,but negatively correlated with MMSE score,MoCA score,N7 dimension score,and AFT results(P<0.05);serum p-Tau-181 level was negatively correlated with MMSE score,MoCA score,and AFT results(P<0.05).Conclusion Serum Aβ1-42 and p-Tau-181 levels in SCD and MCI patients are higher than those in NC patients.Serum Aβ1-42 and p-Tau-181 levels are negatively correlated with global cognition function and language function,which can be considered as auxiliary diagnostic indicators of cognitive function.