Cepek Lukas, Steinacker Petra, Mollenhauer Brit, Wiese Birgitt, Ciesielczyk Barbara, Bibl Mirko, Wiltfang Jens, Zerr Inga, Schulz-Schaeffer Walter, Kretzschmar Hans A, Poser Sigrid, Otto Markus
Department of Neurology, University of Gottingen, Gottingen, Germany.
Dement Geriatr Cogn Disord. 2005;19(5-6):376-82. doi: 10.1159/000084708. Epub 2005 Mar 30.
S-100B and tau protein have a high differential diagnostic potential for the diagnosis of Creutzfeldt-Jakob disease (CJD). So far there has been only limited information available about the dynamics of these parameters in the cerebrospinal fluid (CSF). However, there is a special interest in finding biochemical markers to monitor disease progression for differential diagnosis and treatment.
We analyzed CSF of 45 patients with CJD and of 45 patients with other neurological diseases for tau protein and S-100B in a follow-up setting. All diagnoses of CJD were later neuropathologically verified. A ratio between tau protein differences and the time between lumbar puncture was calculated. The same was done for S-100B.
Tau protein levels of 34 cases were above the cut-off level for CJD (>1,300 pg/ml) in the first CSF sample. In 7 of 11 patients with lower tau levels in the first CSF sample, tau levels rose. The above-mentioned ratio was significantly higher in the CJD group than in the group with other neurological diseases. Similar results were obtained for S-100B.
We conclude that follow-up investigations and calculation of ratios is a useful tool in the differential diagnosis of CJD. Variations in this pattern were observed in single cases.
S-100B蛋白和tau蛋白在克雅氏病（CJD）的诊断中具有较高的鉴别诊断潜力。到目前为止，关于这些参数在脑脊液（CSF）中的动态变化的信息还很有限。然而，寻找生化标志物以监测疾病进展用于鉴别诊断和治疗具有特殊意义。
我们在随访过程中分析了45例CJD患者和45例其他神经系统疾病患者脑脊液中的tau蛋白和S-100B蛋白。所有CJD诊断后来均经神经病理学证实。计算tau蛋白差异与腰椎穿刺时间之间的比率。对S-100B蛋白也进行了同样的计算。
在首次脑脊液样本中，34例患者的tau蛋白水平高于CJD的临界值（>1300 pg/ml）。在首次脑脊液样本中tau水平较低的11例患者中，有7例tau水平升高。CJD组的上述比率显著高于其他神经系统疾病组。S-100B蛋白也得到了类似结果。
我们得出结论，随访调查和比率计算是CJD鉴别诊断的有用工具。个别病例中观察到了这种模式的变化。
