Tapiola T, Pirttilä T, Mehta P D, Alafuzofff I, Lehtovirta M, Soininen H
Department of Neuroscience and Neurology, University Hospital and University of Kuopio, Finland.
Neurobiol Aging. 2000 Sep-Oct;21(5):735-40. doi: 10.1016/s0197-4580(00)00164-0.
We investigated the usefulness of cerebrospinal fluid (CSF) beta-amyloid42 (Abeta42), beta-amyloid40 (Abeta40) and tau analyses in the diagnosis of Alzheimer's disease (AD). The study included 41 definite AD cases, 80 patients with probable AD. 27 with other dementias and 39 neurological controls. Abeta42, Abeta340 and tau protein concentrations in CSF were measured of using ELISA assays. Abeta42 levels were decreased and tau increased in AD. Combination of Abeta42 and tau resulted a sensitivity of 50.4% for AD and specificities of 94.8% for controls and 85.2% for other dementias. Ninety-one percent of the patients with Abeta42 below the cutoff value (340 pg/ml) and tau above the cutoff value (380 pg/ml) had AD. AD patients carrying apoE epsilon4 allele had lower Abeta42 (P < 0.005) and higher tau (P < 0.05) levels than those without an E4 allele, and 18 (81.8%) of the 22 AD patients who had normal Abeta42 and tau levels were apoE e4 allele non-carriers. Low Abeta42 and high tau concentration in CSF strongly support the diagnosis of AD. Measurement of Abeta42 may help the early diagnosis of cases at risk for AD such as apoE E4 allele carriers.
我们研究了脑脊液（CSF）β-淀粉样蛋白42（Aβ42）、β-淀粉样蛋白40（Aβ40）和tau分析在阿尔茨海默病（AD）诊断中的作用。该研究纳入了41例确诊的AD病例、80例可能患有AD的患者、27例患有其他痴呆症的患者以及39例神经学对照者。使用酶联免疫吸附测定法（ELISA）测量脑脊液中Aβ42、Aβ40和tau蛋白的浓度。AD患者的Aβ42水平降低，tau水平升高。Aβ42和tau联合检测对AD的敏感性为50.4%，对对照者的特异性为94.8%，对其他痴呆症患者的特异性为85.2%。Aβ42低于临界值（340 pg/ml）且tau高于临界值（380 pg/ml）的患者中，91%患有AD。携带载脂蛋白Eε4（apoE ε4）等位基因的AD患者的Aβ42水平低于（P < 0.005）且tau水平高于（P < 0.05）不携带E4等位基因的患者，在22例Aβ42和tau水平正常的AD患者中，18例（81.8%）为apoE e4等位基因非携带者。脑脊液中低Aβ42和高tau浓度强烈支持AD的诊断。测量Aβ42可能有助于早期诊断有AD风险的病例，如apoE E4等位基因携带者。
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