Wallin A K, Blennow K, Andreasen N, Minthon L
Department of Psychiatry, Neuropsychiatric Clinic, Malmö University Hospital, Malmö, Sweden.
Dement Geriatr Cogn Disord. 2006;21(3):131-8. doi: 10.1159/000090631. Epub 2006 Jan 2.
Cerebrospinal fluid (CSF) samples from 21 patients with a clinical diagnosis of Alzheimer's disease (AD) participating in a 5-year treatment study with the choline esterase inhibitor tacrin were retrospectively analyzed for the contents of beta-amyloid (Abeta42), total tau (T-tau) and phosphorylated tau (P-tau). A significant positive correlation between the level of P-tau and the number of symptoms according to the DSM-IV criteria (p = 0.041) and the NINCDS-ADRDA (p = 0.029) was observed (i.e. higher levels were found in cases with more symptoms). A significant positive correlation between T-tau, P-tau and ADAS-cog score was identified (i.e. higher levels were found with more severe cognitive dysfunction). Patients who died during the 5-year follow-up had significantly lower levels of Abeta42 (p = 0.011) than those who were still alive. Patients who had died in a 6-year follow-up had significantly lower levels of Abeta42 (p = 0.034) and higher levels of T-tau (p = 0.041) than patients still alive.
CSF biomarkers do aid the clinical diagnosis of AD. Increased levels of P-tau and T-tau are possible markers for severity and abundance of symptoms in AD. Low levels of Abeta42 may indicate a higher risk of early death in AD.
对21例临床诊断为阿尔茨海默病(AD)且参与胆碱酯酶抑制剂他克林为期5年治疗研究的患者的脑脊液(CSF)样本进行回顾性分析,以检测β-淀粉样蛋白(Abeta42)、总tau蛋白(T-tau)和磷酸化tau蛋白(P-tau)的含量。根据《精神疾病诊断与统计手册》第四版标准(p = 0.041)和美国国立神经疾病和中风研究所 - 阿尔茨海默病及相关疾病协会标准(p = 0.029),观察到P-tau水平与症状数量之间存在显著正相关(即症状越多的病例中P-tau水平越高)。确定T-tau、P-tau与ADAS-cog评分之间存在显著正相关(即认知功能障碍越严重,其水平越高)。在5年随访期间死亡的患者的Abeta42水平显著低于仍存活的患者(p = 0.011)。在6年随访中死亡的患者的Abeta42水平显著低于仍存活的患者(p = 0.034),而T-tau水平则显著高于仍存活的患者(p = 0.041)。
脑脊液生物标志物有助于AD的临床诊断。P-tau和T-tau水平升高可能是AD症状严重程度和数量的标志物。Abeta42水平低可能表明AD患者早期死亡风险较高。