Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Neurosci Lett. 2012 May 16;516(2):232-6. doi: 10.1016/j.neulet.2012.03.094. Epub 2012 Apr 7.
Amyloid β and alpha 1-antichymotrypsin (ACT) play an important role in the pathogenesis of sporadic Alzheimer's disease (AD). The present study was to investigate whether a combination of plasma biomarkers and clinical data would discriminate AD from vascular dementia, other neurodegenerative dementia and non-demented controls. The study included 112 patients with AD, 85 patients with vascular dementia, 30 patients with other neurodegenerative dementia and 116 age-matched, non-demented controls. Although ACT, Aβ42 and the ratio of Aβ42/Aβ40 had significant differences between AD, vascular dementia, other neurodegenerative dementia and non-demented controls (P<0.001), none of them reached the sensitivity and specificity required for AD biomarkers. The combination of biomarkers and clinical data had higher discriminating power than either alone. Our results indicated that plasma biomarkers of ACT and the ratio of Aβ42/Aβ40 could discriminate AD from non-demented controls, vascular dementia, or other neurodegenerative dementias with higher diagnostic accuracy than clinical data and that if plasma biomarkers were combined with clinical data, the discriminating power was enhanced.
淀粉样蛋白 β 和 α1-抗糜蛋白酶 (ACT) 在散发性阿尔茨海默病 (AD) 的发病机制中发挥重要作用。本研究旨在探讨血浆生物标志物与临床数据的联合应用是否能将 AD 与血管性痴呆、其他神经退行性痴呆和非痴呆对照组区分开来。该研究纳入了 112 例 AD 患者、85 例血管性痴呆患者、30 例其他神经退行性痴呆患者和 116 名年龄匹配的非痴呆对照组。尽管 ACT、Aβ42 和 Aβ42/Aβ40 的比值在 AD、血管性痴呆、其他神经退行性痴呆和非痴呆对照组之间存在显著差异（P<0.001），但它们均未达到 AD 生物标志物所需的灵敏度和特异性。生物标志物与临床数据的联合应用具有更高的鉴别能力。我们的研究结果表明，ACT 血浆生物标志物和 Aβ42/Aβ40 的比值可提高 AD 与非痴呆对照组、血管性痴呆或其他神经退行性痴呆的诊断准确性，优于临床数据，并且如果将血浆生物标志物与临床数据相结合，鉴别能力将得到增强。
