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阿尔茨海默病患者血清神经元特异性烯醇化酶和高敏C反应蛋白表达水平及其临床意义

Serum Neuron-Specific Enolase and High-Sensitivity C-Reactive Protein Expression Levels and Their Clinical Significance in Patients With Alzheimer's Disease.

作者信息

Zhou Zhangning, Zhao Feimin

机构信息

Department of Geriatric Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, Zhejiang, China.

出版信息

Br J Hosp Med (Lond). 2025 Jul 25;86(7):1-15. doi: 10.12968/hmed.2025.0074. Epub 2025 Jul 22.

Abstract

Alzheimer's disease (AD) is a degenerative disease of the central nervous system. Identifying effective and highly specific serum biomarkers is crucial for the early diagnosis and therapeutic monitoring of AD. This study aimed to explore the serum levels of neuron-specific enolase (NSE) and high-sensitivity C-reactive protein (hs-CRP) and their clinical significance in AD patients. This retrospective study recruited 112 AD patients hospitalized between June 2021 and June 2023 as an AD group. For comparison, 80 healthy individuals who underwent physical examination during the same period were selected as the control group. The levels of NSE and hs-CRP were assessed using enzyme-linked immunosorbent assay (ELISA). The levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were also determined using ELISA. Furthermore, the severity of cognitive impairment was evaluated using the Mini-mental State Examination (MMSE) score, the Global Deterioration Scale (GDS), and the Clinical Dementia Rating Scale (CDR). Pearson correlation analysis was used to analyze the correlation between serum NSE and hs-CRP levels and disease-related indicators in the AD group, and the receiver operating characteristic (ROC) was used to analyze their diagnostic efficacy. The AD group exhibited significantly higher GDS and CDR scores, as well as serum NSE and hs-CRP levels, and significantly lower MMSE scores compared to the control group ( < 0.001). GDS and CDR scores, and serum NSE and hs-CRP levels were significantly higher in the moderate-to-severe group than in the mild group, and significantly lower MMSE scores ( < 0.001). Pearson correlation analysis revealed that serum NSE and hs-CRP levels were negatively correlated with MMSE scores in AD patients ( < 0.05) and were positively correlated with GDS and CDR scores ( < 0.05). ROC curve analysis showed that the serum NSE (area under the curve [AUC]: 0.856, 95% CI 0.787-0.925, < 0.001) and hs-CRP (AUC: 0.728, 95% CI 0.631-0.825, < 0.001) levels individually had significant diagnostic efficacy for AD; however, the combined assessment of their levels (AUC: 0.879, 95% CI 0.815-0.943, < 0.001) demonstrated higher diagnostic efficacy than hs-CRP alone ( < 0.001). Serum NSE and hs-CRP levels are closely associated with the cognitive function in AD patients, and their combined evaluation exhibits a higher diagnostic value.

摘要

阿尔茨海默病(AD)是一种中枢神经系统退行性疾病。识别有效且高度特异的血清生物标志物对于AD的早期诊断和治疗监测至关重要。本研究旨在探讨神经元特异性烯醇化酶(NSE)和高敏C反应蛋白(hs-CRP)的血清水平及其在AD患者中的临床意义。这项回顾性研究纳入了2021年6月至2023年6月期间住院的112例AD患者作为AD组。为作比较,选取同期进行体检的80名健康个体作为对照组。采用酶联免疫吸附测定(ELISA)法评估NSE和hs-CRP水平。还使用ELISA法测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平。此外,使用简易精神状态检查表(MMSE)评分、总体衰退量表(GDS)和临床痴呆评定量表(CDR)评估认知障碍的严重程度。采用Pearson相关性分析来分析AD组血清NSE和hs-CRP水平与疾病相关指标之间的相关性,并使用受试者工作特征(ROC)曲线分析其诊断效能。与对照组相比,AD组的GDS和CDR评分以及血清NSE和hs-CRP水平显著更高,而MMSE评分显著更低(<0.001)。中度至重度组的GDS和CDR评分以及血清NSE和hs-CRP水平显著高于轻度组,而MMSE评分显著更低(<0.001)。Pearson相关性分析显示,AD患者血清NSE和hs-CRP水平与MMSE评分呈负相关(<0.05),与GDS和CDR评分呈正相关(<0.05)。ROC曲线分析表明,血清NSE(曲线下面积[AUC]:0.856,95%可信区间0.787-0.925,<0.001)和hs-CRP(AUC:0.728,95%可信区间0.631-0.825,<0.001)水平单独对AD均具有显著诊断效能;然而,联合评估它们的水平(AUC:0.879,95%可信区间0.815-0.943,<0.001)显示出比单独hs-CRP更高的诊断效能(<0.001)。血清NSE和hs-CRP水平与AD患者的认知功能密切相关,联合评估具有更高的诊断价值。

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