脑脊液生物标志物特征及其在血管性痴呆中的诊断价值

CSF biomarker profile and diagnostic value in vascular dementia.

作者信息

Paraskevas G P, Kapaki E, Papageorgiou S G, Kalfakis N, Andreadou E, Zalonis I, Vassilopoulos D

机构信息

Department of Neurology, School of Medicine, Athens National University, Athens, Greece.

出版信息

Eur J Neurol. 2009 Feb;16(2):205-11. doi: 10.1111/j.1468-1331.2008.02387.x.

DOI:10.1111/j.1468-1331.2008.02387.x

PMID:19146641

Abstract

BACKGROUND AND PURPOSE

The differential diagnosis between vascular dementia (VD) and Alzheimer's disease (AD) or mixed dementia (MD) is not always easy in clinical practice. The purpose of the present study was to evaluate the cerebrospinal fluid (CSF) biomarkers tau protein in its total (tau(T)) or hyperphosphorylated at threonin-181(tau(P-181)) form and beta amyloid peptide 1-42 (A beta 42) alone and their combinations to investigate their diagnostic value in the discrimination between VD and AD or MD.

METHODS

The above CSF biomarkers were determined in duplicate and blind to the clinical diagnosis by double sandwich, enzyme-linked immunosorbent assay (ELISA) commercial kits (Innogenetics, Gent, Belgium) in 92 AD patients, 23 VD patients, 17 patients with MD and 68 controls.

RESULTS

Alzheimer's disease and MD showed increased levels of tau(T), tau(P) and reduced levels of A beta 42 as compared with the controls. The best discrimination between VD and AD or MD was achieved by the combination of all three biomarkers, correctly classifying >or=85% of patients, either in the form of a discriminant function or in the form of the tau(T) x tau(P-181)/A beta 42 formula.

CONCLUSIONS

Cerebrospinal fluid biomarkers may be a useful adjunct for the discrimination between AD/ MD and VD in every day clinical practice.

摘要

背景与目的

在临床实践中，血管性痴呆（VD）与阿尔茨海默病（AD）或混合性痴呆（MD）之间的鉴别诊断并非总是容易的。本研究的目的是评估脑脊液（CSF）生物标志物总tau蛋白（tau(T)）或苏氨酸-181位点磷酸化的tau蛋白（tau(P-181)）以及单独的β淀粉样肽1-42（Aβ42）及其组合，以研究它们在鉴别VD与AD或MD中的诊断价值。