阿尔茨海默病痴呆标志物的相关性

H. Akhondi
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摘要

阿尔茨海默病仍然是老年痴呆症患者发病、死亡和依赖的主要原因。随着西半球老年人口年龄的增长和痴呆症的增加,一种廉价和统一的老年痴呆症早期诊断方法至关重要。方法:在一项前瞻性单盲研究中,我们试图研究单光子发射计算机断层扫描(SPECT)脑成像作为一种更便宜的方式,在一组诊断为可能的阿尔茨海默氏痴呆症的队列中。获得患者的人口统计学、家族史、Mini Mental Status Exam、脑成像、Tau、淀粉样蛋白、Apo E基因型等生物标志物并进行分析。我们使用卡方检验检验了当前阿尔茨海默病诊断与SPECT和生物标志物之间的不同可能的相关模型。结果:生物化学标志物(淀粉样蛋白β 42和tau蛋白)在识别AD患者中具有较高的敏感性。APOE基因型作为诊断测试的敏感性较低。SPECT与早期AD的生物标志物无相关性,但与中度和重度痴呆的相关性较高。有必要进一步研究,以确定一种更敏感、更特异、更廉价的检测方法,用于阿尔茨海默病的早期诊断。讨论:与生物化学和遗传标记与阿尔茨海默病患者脑成像的关系相比,它们彼此之间以及与阿尔茨海默病的关系更为密切。
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Correlation of Alzheimer’s Dementia Markers
Introduction: Alzheimer’s disease remains a major cause of morbidity, mortality and dependency in older patients with dementia. With increasing age in older population and dementia in western hemisphere, an inexpensive and unified modality for early diagnosis of AD is of utmost importance. Methods: We sought to investigate single photon emission computed tomography (SPECT) imaging of the brain as a less expensive modality in a prospective single blinded study in a cohort with diagnosis of probable Alzheimer’s dementia. Patients’ demographics, family history, Mini Mental Status Exam, brain imaging, biomarkers such as Tau, Amyloid beta protein, and Apo E genotype were obtained and analyzed. We tested different possible correlations models for association of current diagnosis of Alzheimer’s disease with SPECT and biomarkers using Chi-square test. Results: Biochemical markers (Amyloid beta 42 and tau protein) have higher sensitivity in identifying patients with AD. APOE genotype is less sensitive as a diagnostic test. SPECT did not correlate with biomarkers in early AD, but showed higher correlation in moderate and severe dementia. Further investigation is warranted to identify a more sensitive and specific yet inexpensive testing for early diagnosis of AD. Discussion: Biochemical and genetic markers have a closer association with each other and with Alzheimer’s compared to their association with brain imaging of patients with Alzheimer’s disease.
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