血清神经丝轻链蛋白与认知障碍的相关性研究

Study on the correlation between serum neurofilament light chain protein and cognitive impairment

目的 研究包括轻度认知障碍(MCI)、阿尔茨海默病(AD)、血管性痴呆(VD)诊断在内的认知障碍疾病中血清神经丝轻链蛋白(NFL)水平测定的临床意义。方法 收集门诊及住院确诊认知功能障碍的住院患者,根据纳入及排除标准分为MCI组47例、 AD组46例、 VD组43例及在门诊体检的健康人群45例作为正常对照组,其中AD组及VD组根据病情严重程度分为轻度组及中重度组,所有患者在确诊后当天进行认知功能评价,在确诊后第二天清晨行血清NFL检查。结果 4组之间的血清NFL水平的比较差异有统计学意义(P<0.05);组间两两比较中,MCI组和AD组的血清NFL水平之间的比较差异无统计学意义(P>0.05);亚组分析中AD组轻度痴呆患者与中重度痴呆患者的血清NFL水平的比较,中重度痴呆患者的血清NFL水平高于轻度痴呆患者,差异有统计学意义(P<0.05);VD组轻度痴呆患者与中重度痴呆患者的血清NFL水平的比较,中重度痴呆患者的血清NFL水平高于轻度痴呆患者,差异有统计学意义(P<0.05)。结论 血清NFL水平检测在临床中可以作为AD及VD早期诊断和病情严重程度判断的外周血生物标志物。

Objective To investigate the correlation between serum neurofilament light chain protein(NFL)levels and cognitive impairment diseases,including mild cognitive impairment(MCI),Alzheimer′s disease(AD),vascular dementia(VD).Methods According to the inclusion and exclusion criteria,the hospitalized patients diagnosed with cognitive impairment were collected and divided into MCI group(47 cases),AD group(46 cases),VD group(43 cases)and normal control group(45 cases).The AD group and VD group were divided into mild group and moderate to severe group based on the severity of the disease.All patients underwent cognitive function assessment and the serum NFL levels were detected.Results There was a significant statistical difference in serum NFL concentration among the four groups(P<0.05).There was no significant difference in serum NFL concentration between MCI group and AD group(P>0.05).The serum NFL concentration in VD group was significantly higher than the other three groups.There was a significant difference in serum NFL concentration between mild dementia and moderate to severe dementia patients in AD group(P<0.05).There was a significant difference in serum NFL concentration between mild dementia and moderate to severe dementia patients in VD group(P<0.05).Conclusion The serum NFL level can be used as a peripheral blood biomarker for the early diagnosis and severity assessment of AD and VD.