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中华脑科疾病与康复杂志(电子版) ›› 2024, Vol. 14 ›› Issue (04) : 208 -212. doi: 10.3877/cma.j.issn.2095-123X.2024.04.003

临床研究

Hcy和AD7c-NTP在阿尔茨海默病诊断中的临床应用
杨森1,†(), 阙玉梅1, 丁莉1, 王艺瑾1, 侯庆宇1   
  1. 1.617000 四川攀枝花，攀钢集团总医院神经内科
  • 收稿日期:2023-12-01 出版日期:2024-08-15
  • 通信作者: 杨森

Clinical application of Hcy and AD7c-NTP in the diagnosis of Alzheimer's disease

Sen Yang1,†(), Yumei Que1, Li Ding1, Yijin Wang1, Qingyu Hou1   

  1. 1.Department of Neurology, Pangang Group General Hospital,Panzhihua 617000, China
  • Received:2023-12-01 Published:2024-08-15
  • Corresponding author: Sen Yang
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引用本文：

杨森, 阙玉梅, 丁莉, 王艺瑾, 侯庆宇. Hcy和AD7c-NTP在阿尔茨海默病诊断中的临床应用[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(04): 208-212.

Sen Yang, Yumei Que, Li Ding, Yijin Wang, Qingyu Hou. Clinical application of Hcy and AD7c-NTP in the diagnosis of Alzheimer's disease[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2024, 14(04): 208-212.

目的

探讨同型半胱氨酸（Hcy）和阿尔茨海默病（AD）相关性神经丝蛋白（AD7c-NTP）在AD 患者诊断中的临床应用。

方法

选取攀钢集团总医院神经内科自2021年9月至2022年7月收治的82例AD患者作为研究组，再按照认知障碍程度分为轻度组（51例）和中重度组（31例）；选取同期健康志愿者82例作为对照组。比较研究组和对照组、轻度组和中重度组血浆Hcy、尿AD7c-NTP水平，采用二元Logistic 回归分析并绘制受试者工作特征（ROC）曲线研究血浆Hcy、尿AD7c-NTP 以及二者联合对AD 的诊断价值。

结果

研究组血浆Hcy、尿AD7c-NTP 水平明显高于对照组，轻度组血浆Hcy、尿AD7c-NTP 水平明显低于中重度组，差异均有统计学意义（P＜0.05）。ROC 曲线分析显示，血浆Hcy、尿AD7c-NTP、二者联合诊断AD 的曲线下面积分别为0.812、0.803、0.867，最佳临界值分别为19.5 μmol/L、1.545 ng/mL、43.426，约登指数分别为0.549、0.463、0.597，在最佳临界值点对应的敏感度、特异度分别为54.9%、100.0%，96.3%、50.0%，84.1%、75.6%。

结论

AD患者血浆Hcy、尿AD7c-NTP呈高表达，且认知障碍程度越严重其表达越高，二者联合对AD具有较高的诊断价值。

关键词: 阿尔茨海默病, 同型半胱氨酸, 阿尔茨海默病相关性神经丝蛋白, 诊断

Objective

To investigate the clinical application of homocysteine(Hcy)and Alzheimerassociated neuronal thread protein (AD7c-NTP) in the diagnosis of Alzheimer's disease (AD) patients.

Methods

Eighty-two AD patients diagnosed and treated in Neurology Department of Pangang Group General Hospital from September 2021 to July 2022 were selected as the study group, and 82 healthy volunteers during the same period were selected as the control group.AD patients of the study group were divided into mild group (51 cases) and moderate to severe group (31 cases) according to the degree of cognitive impairment.The levels of plasma Hcy and urine AD7c-NTP were compared between the study group and the control group, as well as between the mild and moderate to severe groups.The binary Logistic regression analysis and receiver operating characteristic (ROC) curve were used to study the diagnostic value of plasma Hcy, urine AD7c-NTP, and their combination for AD.

Results

The plasma Hcy and urine AD7c-NTP levels in the study group were significantly higher than those in the control group (P＜0.05).The plasma Hcy and urine AD7c-NTP levels in the mild group were significantly lower than those in the moderate to severe group (P＜0.05).The ROC curve analysis showed that the area under the curve for diagnosing AD with plasma Hcy,urine AD7c-NTP,and their combination were 0.812,0.803,and 0.867, respectively; the optimal critical values were 19.5 μmol/L, 1.545 ng/mL, and 43.426,respectively;the Jordan index was 0.549,0.463,and 0.597,respectively.The sensitivity and specificity at the optimal critical points were 54.9%and 100.0%for Hcy,96.3%and 50.0%for AD7c-NTP,and 84.1%and 75.6%for the combination of the two.

Conclusion

The expression of plasma Hcy and urine AD7c-NTP is high in AD patients, and the more severe the cognitive impairment of AD patients, the higher the expression of plasma Hcy and urine AD7c-NTP; The combination of plasma Hcy and urine AD7c-NTP has high diagnostic value for AD.

Key words: Alzheimer ' s disease, Homocysteine, Alzheimer - associated neuronal thread protein, Diagnosis
表1 2组受试者的基线资料比较
Tab.1 Comparison of baseline data between two groups
组别 例数 年龄（岁，Mean±SD） 性别[例（%）] 体质量指数（kg/m2，Mean±SD） 文化程度[例（%）]
男 女 文盲 小学 中学及以上
对照组 82 71.12±5.35 39（47.56） 43（52.44） 21.46±2.81 12（14.63） 52（63.41） 18（21.95）
研究组 82 71.54±5.29 40（48.78） 42（51.22） 21.61±2.45 12（14.63） 50（60.98） 20（24.39）
t/χ2值 0.506 0.024 0.364 0.078
P值 0.614 0.876 0.716 0.78
表2 研究组与对照组患者的血浆Hcy、尿AD7c-NTP水平比较（Mean±SD）
Tab.2 Comparison of plasma Hcy and urine AD7c-NTP levels between the study group and the control group(Mean±SD)
组别 例数 Hcy（μmol/L） AD7c-NTP（ng/mL）
对照组 82 13.89±4.15 1.65±0.45
研究组 82 21.88±8.26 2.22±0.39
t值 7.832 8.667
P值 ＜0.001 ＜0.001
表3 研究组不同认知障碍程度患者的血浆Hcy、尿AD7c-NTP水平比较（Mean±SD）
Tab.3 Comparison of plasma Hcy and urine AD7c-NTP levels in different degrees of cognitive impairment in the study group(Mean±SD)
组别 例数 Hcy(μmol/L） AD7c-NTP(ng/mL）
轻度组 51 18.58±5.87 2.08±0.32
中重度组 31 27.32±8.81 2.45±0.39
t值 -4.672 -5.393
P值 ＜0.001 ＜0.001
图1 血浆Hcy、尿AD7c-NTP诊断AD的ROC曲线分析
Fig.1 ROC curve analysis of plasma Hcy and urine AD7c-NTP in diagnosing AD
表4 血浆Hcy、尿AD7c-TP诊断AD的二元Logisic回归分析结果
Tab.4 Binary Logistic regression analysis of plasma Hcy and urine AD7c-NTP in diagnosing AD
因素 偏回归系数 标准误 Wald值 P值 OR值 95%CI
Hcy 0.148 0.041 13.019 ＜0.001 1.159 1.070～1.256
AD7c-NTP 2.317 0.551 17.677 ＜0.001 10.141 3.444～29.859
常量 -6.993 1.131 38.258 ＜0.001 0.001 -
表5 血浆Hcy、尿AD7c-NTP诊断AD的AUC比较
Tab.5 Comparison of AUC between plasma Hcy and urine AD7c-NTP in diagnosing AD
项目 AUC 标准误 P值 95%CI
Hcy 0.812 0.033 ＜0.001 0.748～0.877
AD7c-NTP 0.803 0.033 ＜0.001 0.739～0.868
二者联合 0.867 0.027 ＜0.001 0.813～0.921
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