胱抑素C和高密度脂蛋白胆固醇在阿尔茨海默病及血管性痴呆患者血清中的表达及其临床应用

Expression and clinical application of serum cystatin C and high-density lipoprotein cholesterol in AD and VD patients

目的 探究胱抑素C(Cys C)、高密度脂蛋白胆固醇(HDL-C)在阿尔茨海默病(AD)和血管性痴呆(VD)患者血清中的表达水平,及其在2种疾病中的临床应用。方法 纳入2020年1月至2022年1月金华市第二医院收治的AD患者40例作为AD组,VD患者40例作为VD组,另选取同期我院健康体检者40例作为对照组;根据蒙特利尔认知评估量表(MoCA)评分将AD和VD患者分为轻度AD组22例、轻度VD组24例(MoCA评分18~26分),中重度AD组18例、中重度VD组16例(MoCA评分≤17分)。检测血清Cys C、HDL-C含量;ROC曲线分析血清Cys C、HDL-C对AD及VD的诊断效能。结果 AD组和VD组总胆固醇、三酰甘油、低密度脂蛋白胆固醇、Cys C水平高于对照组,HDL-C水平低于对照组(P<0.05)。中重度AD组和中重度VD组Cys C水平高于轻度AD组和轻度VD组(P<0.05);中重度AD组、中重度VD组、轻度AD组、轻度VD组HDL-C水平比较无统计学差异(P>0.05)。Cys C和HDL-C联合诊断AD和VD的曲线下面积分别为0.980(95%CI:0.943~1.000)和0.951(95%CI:0.905~0.996)。结论 Cys C、HDL-C检测便捷,在AD和VD患者血清中的水平与健康人群存在差异,可能成为筛查AD和VD的参考指标。

Objective To investigate the expression of cystatin C(Cys C)and high-density lipopro-tein cholesterol(HDL-C)in the serum of patients with Alzheimer's disease(AD)and vascular dementia(VD),and their clinical application.Methods A total of 40AD patients(AD group)and 40VD patients(VD group)admitted to Jinhua Second Hospital from January 2020to January 2022were enrolled,and another 40healthy individuals who taking physical examination in the hospital during the same period were subjected as control group.According to Montreal Cognitive Assessment Scale(MoCA)score,the AD patients were divided into mild(22cases)and moderate to severe(18cases)AD groups,and the VD patients were into mild(MoCA score 18-26,24 cases)and moderate to severe(MoCA score<17,16cases)VD group.Serum levels of Cys C and HDL-C were detected in all the participants,and the diagnostic efficacy of serum Cys C and HDL-C level for AD and VD was analyzed with ROC curve analysis.Results The serum levels of TC,TG,LDL-C and Cys C were significantly higher,and that of HDL-C was obviously lower in the AD and VD groups than the control group(P<0.05).The Cys C level in the moderate to severe AD group and the moderate to severe VD group was higher than that in the mild AD group and the mild VD group(P<0.05).There was no significant difference in HDL-C level among moder-ate to severe AD group,moderate to severe VD group,mild AD group and mild VD group(P>0.05).The AUC value for the combined Cys C and HDL-C for diagnosis of AD and VD were 0.980(95%CI:0.943-1.000)and 0.951(95%CI:0.905-0.996),respectively.Conclusion Detec-ting serum Cys C and HDL-C levels is simple and convenient.There are significant differences in their serum levels in the patients with AD and VD when compared with healthy population,which may become reference indicators for screening AD and VD.