Pantoni L, Inzitari D, Pracucci G, Lolli F, Giordano G, Bracco L, Amaducci L
Department of Neurological and Psychiatric Sciences, University of Florence, Italy.
J Neurol Sci. 1993 Apr;115(2):125-31. doi: 10.1016/0022-510x(93)90214-j.
Some CSF protein abnormalities have been proposed as a possible marker for vascular dementia. We studied the CSF protein levels and albumin ratio in 21 patients (mean age 64.04 +/- 7.5) with progressive bilateral motor impairment, and a CT picture of leucoaraiosis. Seven of these patients also presented with dementia. Twenty-seven Alzheimer's disease patients (mean age 59.59 +/- 5.30) without leucoaraiosis were taken as controls. We also evaluated the correlations of the albumin ratio values with the diagnosis of dementia, the severity of cognitive impairment, the degree of cerebral atrophy and presence of infarcts on CT, and the abnormalities in CSF circulation, found on isotopic cisternography, in the leucoaraiosis group. After controlling for age and sex, the patients with leucoaraiosis showed greater CSF albumin levels (0.27 g/l +/- 0.11 vs. 0.21 g/l +/- 0.06; covariance analysis P = 0.066), CSF IgG values (4.68 mg/100 ml +/- 1.45 vs. 2.85 mg/100 ml +/- 1.03; covariance analysis P < 0.001), and a higher albumin ratio (0.0078 +/- 0.0027 vs. 0.0058 +/- 0.0019; covariance analysis P = 0.013) than those with Alzheimer's disease. The variations of these parameters were not apparently related to the presence of dementia in the leucoaraiosis group. A significantly higher albumin ratio was observed in patients with a slowed CSF circulation compared to those with normal CSF circulation (0.0086 +/- 0.0028 vs. 0.0059 +/- 0.0019; covariance analysis P = 0.05). We conclude that, independently from the presence of dementia, patients with leucoaraiosis have CSF abnormalities consistent with functional blood-brain barrier alterations.
一些脑脊液蛋白异常已被提出可能作为血管性痴呆的标志物。我们研究了21例（平均年龄64.04±7.5岁）患有进行性双侧运动障碍且有脑白质疏松CT影像的患者的脑脊液蛋白水平和白蛋白比率。其中7例患者还伴有痴呆。选取27例无脑白质疏松的阿尔茨海默病患者（平均年龄59.59±5.30岁）作为对照。我们还评估了脑白质疏松组中白蛋白比率值与痴呆诊断、认知障碍严重程度、脑萎缩程度、CT上梗死灶的存在以及同位素脑池造影发现的脑脊液循环异常之间的相关性。在控制年龄和性别后，脑白质疏松患者的脑脊液白蛋白水平更高（0.27 g/l±0.11 vs. 0.21 g/l±0.06；协方差分析P = 0.066），脑脊液IgG值更高（4.68 mg/100 ml±1.45 vs. 2.85 mg/100 ml±1.03；协方差分析P < 0.001），白蛋白比率也更高（0.0078±0.0027 vs. 0.0058±0.0019；协方差分析P = 0.013），高于阿尔茨海默病患者。在脑白质疏松组中，这些参数的变化与痴呆的存在并无明显关联。与脑脊液循环正常的患者相比，脑脊液循环减慢的患者白蛋白比率显著更高（0.0086±0.0028 vs. 0.0059±0.0019；协方差分析P = 0.05）。我们得出结论，独立于痴呆的存在，脑白质疏松患者存在与功能性血脑屏障改变一致的脑脊液异常。
