血及脑脊液β-淀粉样蛋白对老年期痴呆鉴别诊断的意义

目的:探讨血及脑脊液中β-淀粉样蛋白(β-AP)对老年期痴呆主要包括老年性痴呆(AD)、血管性痴呆(VD)及其他原因所致的痴呆(OD)的鉴别诊断意义。方法:采用平衡饱和竞争放射免疫分析法对55例不同类型的痴呆患者及30例正常对照者血清及脑脊液(CSF)中β-AP进行测定。结果:在正常对照组,随着观察者年龄的增长,血清β-AP含量缓慢增高,CSF中β-AP含量缓慢下降(r分别为0.56,0.52,均P<0.01)。不同病因痴呆患者血清β-AP含量均高于对照组,其中AD组最明显;CSF中β-AP含量在AD组最低,明显低于对照组(P<0.01),在VD组最高,接近对照组(P>0.05)。AD组中的重度痴呆患者,其β-AP含量在血清中升高最明显,同时在CSF中降低也最显著。结论:血清及CSF中β-AP含量变化的测定,可能有助于各型痴呆的鉴别诊断及AD患者病情轻重的判断,但这种变化具重叠性。

The differential diagnostic value of β- AP in blood and cerebrospinal fluid in senile dementia

Objective: To probe into the differential diagnostic value of β-AP in blood serum and cerebrospinal fluid (CSF) in senile dementia, which mainly includes Alzheimer disease(AD), Vascular dementia(VD) and Other dementia (OD). Methods: The serum and CSF levels of β-AP in 55 patients with senile dementia and normal controls (NO were measured by radio-immunoassay (RIA)method. Results: With aging of NC, levels ofβ-AP in serum were gradually increasing, and levels of β-AP in CSF were slowly decreasing(r =0. 56 ,0. 52 respectively. P<0. 01 ).β-AP in serum in all kinds of dementia patients were higher than in controls', this phenomenon was more significant in AD group.β-AP in CSF was the lowest in AD group and the highest in VD group, the former was obviously lower than in controls(P<0. 01),the latter was close to controls'. In AD group, the more serious patients were , the higher β-AP in serum were, at the moment, β-AP in CSF in these patients were the lowest. Conclusion: This study indicates that detecting β-AP in serum and CSF may help to diagnosticate all kinds of dementias and estimate the degree of AD , but the change aboutβ-AP has superposition.