老年阿尔茨海默型痴呆和宾斯万格病患者脑脊液中β-内啡肽、高香草酸和5-羟吲哚乙酸的研究

CSF beta-endorphin, HVA and 5-HIAA of dementia of the Alzheimer type and Binswanger's disease in the elderly.

作者信息

Lee S, Chiba T, Kitahama T, Kaieda R, Hagiwara M, Nagazumi A, Terashi A

机构信息

Second Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

出版信息

J Neural Transm Suppl. 1990;30:45-55. doi: 10.1007/978-3-7091-3345-3_5.

DOI:10.1007/978-3-7091-3345-3_5

PMID:1697333

Abstract

Cerebrospinal fluid (CSF) concentration of beta-endorphin (beta-Ep), homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) was measured in 15 patients with dementia of the Alzheimer type (DAT) and in 16 patients suspected of having Binswanger's disease (BD) by MRI, which sometimes resembles DAT clinically. These were classified into three stages according to severity of dementia, Stage 1 (mild dementia)-Stage 3 (severe dementia). CSF levels of HVA decreased significantly in severe dementia, but the level of 5-HIAA did not correlate with dementia severity in both dementia groups. beta-Ep levels did not differ significantly between any stages of DAT, and among controls. beta-Ep levels, however, in BD Stage 1 (27.5 +/- 5.9 pg/ml) were significantly higher (p less than 0.05), but level in Stage 3 (6.7 +/- 2.0) was significantly lower (p less than 0.001) than in the controls (19.2 +/- 4.5). These results suggest that CSF beta-Ep may depend on the cause of dementia rather than severity of dementia, and could possibly distinguish the closely resembling BD from true DAT.

摘要

对15例阿尔茨海默型痴呆（DAT）患者和16例经磁共振成像（MRI）怀疑患有宾斯旺格病（BD）的患者测定了脑脊液（CSF）中β-内啡肽（β-Ep）、高香草酸（HVA）和5-羟吲哚乙酸（5-HIAA）的浓度，BD在临床上有时与DAT相似。根据痴呆严重程度将这些患者分为三个阶段，即1期（轻度痴呆）至3期（重度痴呆）。在重度痴呆患者中，CSF中HVA水平显著降低，但在这两组痴呆患者中，5-HIAA水平与痴呆严重程度均无相关性。在DAT的任何阶段与对照组之间，β-Ep水平均无显著差异。然而，BD 1期患者的β-Ep水平（27.5±5.9 pg/ml）显著高于对照组（19.2±4.5）（p<0.05），而3期患者的β-Ep水平（6.7±2.0）显著低于对照组（p<0.001）。这些结果表明，CSF中β-Ep可能取决于痴呆的病因而非痴呆的严重程度，并且可能有助于将与DAT极为相似的BD区分开来。