非痴呆血管性认知障碍患者血清p-tau-181Aβ_(1-42)及sLOX-1在早期诊断中的意义

Significance of serum p-tau-181,Αβ_(1-42),sLOX-1 detection in the early diagnosis of non-dementia patients with vascular cognitive impairment

目的探讨血清磷酸化tau蛋白-181(p-tau-181)、β淀粉样蛋白_(1-42)(Αβ_(1-42))、可溶性凝集素样氧化型低密度脂蛋白受体1(sLOX-1)在非痴呆血管性认知障碍患者早期诊断中的临床意义。方法选取2022-04—2023-03临汾市人民医院收治的102例非痴呆血管性认知障碍患者为研究组,以同期在我院体检的110例健康者为对照组。所有纳入对象入院后均采用酶联免疫吸附法检测血清p-tau-181、Αβ_(1-42)、sLOX-1水平,并进行组间比较。采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评价血清p-tau-181、Αβ_(1-42)、sLOX-1对非痴呆血管性认知障碍的早期诊断价值,同时采用二分类Logistic逐步回归分析非痴呆血管性认知障碍的危险因素。结果研究组血清p-tau-181、Αβ_(1-42)、sLOX-1水平均高于对照组(P<0.05)。血清p-tau-181、Αβ_(1-42)、sLOX-1诊断非痴呆血管性认知障碍患者的AUC为0.762(95%CI:0.712~0.812)、0.833(95%CI:0.783~0.883)、0.867(95%CI:0.827~0.907),三者联合早期诊断非痴呆血管性认知障碍患者的AUC为0.917(95%CI:0.867~0.967)。二分类Logistic逐步回归分析显示,Hcy[OR(95%CI)=2.707(1.611~4.551)]、p-tau-181[OR(95%CI)=3.047(1.736~5.347)]、Αβ_(1-42)[OR(95%CI)=2.192(1.422~3.381)]、sLOX-1[OR(95%CI)=3.404(1.883~6.153)]均为影响非痴呆血管性认知障碍发生的相关因素(P<0.05)。结论非痴呆血管性认知障碍患者血清p-tau-181、Αβ_(1-42)、sLOX-1水平均升高,且均可作为早期诊断的有效指标,三者联合能更有效评估非痴呆血管性认知障碍。

Objective To investigate the clinical significance of serum phosphorylated tau protein 181(p-tau-181),β-amyloid protein _(1-42)(Αβ_(1-42))and soluble lectin like oxidized low density lipoprotein receptor-1(sLOX-1)detection in the early diagnosis of non-dementia patients with vascular cognitive impairment.Methods A total of 102 patients with non-dementia vascular cognitive impairment admitted to Linfen People’s Hospital from April 2022 to March 2023 were selected as the study group,and 110 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.Serum levels of p-tau-181,Αβ_(1-42) and sLOX-1 were measured by enzyme-linked immunosorbent assay after admission and compared among all groups.The value of serum p-tau-181,Αβ_(1-42) and sLOX-1 in the early diagnosis of non-dementia vascular cognitive impairment was evaluated by receiver operating characteristic(ROC)curve and area under the curve(AUC),and the risk factors for non-dementia vascular cognitive impairment were analyzed by binary Logistic stepwise regression.Results Serum levels of p-taU-181,Αβ_(1-42) and sLOX-1 in the study group were higher than those in the control group(P<0.05).The AUC of serum p-tau-181,Αβ_(1-42),sLOX-1 in the diagnosis of patients with non-dementia vascular cognitive impairment was 0.762(95%CI:0.712-0.812),0.833(95%CI:0.783-0.883),0.867(95%CI:0.827-0.907),respectively,and the AUC of combination of three indicators in the diagnosis of patients with non-dementia vascular cognitive impairment was 0.917(95%CI:0.867-0.967).Binary Logistic stepwise regression analysis showed that Hcy(OR(95%CI)=2.707(1.611-4.551)),p-tau-181(OR(95%CI)=3.047(1.736-5.347)),Αβ_(1-42)(OR(95%CI)=2.192(1.422-3.381)),sLOX-1(OR(95%CI)=3.404(1.883-6.153))were associated with the occurrence of non-dementia vascular cognitive impairment(P<0.05).Conclusion Serum levels of p-tau-181,Aβ_(1-42) and sLOX-1 were elevated in non-dementia patients with vascular cognitive impairment,and all of them could be used as effective indicators for early diagnosis.The combination of the three could be more effective in evaluating non-dementia vascular cognitive impairment.