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目的探讨和比较数种神经蛋白质对 Creutzfeldt-Jakob 病(CJD)的早期诊断价值。方法对14例发病2个月内 CJD 取脑脊液,采用蛋白捕捉法和酶联免疫试验对总 tau 蛋白(t-tau)、磷酸化 tau 蛋白(p-tau)、t-tau 蛋白与 p-tau 蛋白比值(t-tau/p-tau)、S-100β蛋白、14-3-3蛋白及14-3-2蛋白进行定量检测,同时设非 CJD 痴呆(OD,11例)和无痴呆(ND,18例)的对照组。结果 (1)t-tau蛋白:CJD 组、OD 组和 ND 组分别是8295、300、161 pg/ml。p-tau/t-tau 值分别是0.0092、0.2258、0.2471。(2)S-100β蛋白:CJD 组、OD 组、ND 组分别是1.576、0.639、0.239 ng/ml。(3)14-3-3蛋白:CJD 组、OD 组、ND 组分别是40.00、2.65、3.10 ng/ml。(4)14-3-2蛋白:CJD 组、OD 组与 ND 组分别是48.43、14.00、20.50 ng/ml。(5)t-tau≥500 pg/ml 为阈值点,敏感度为84.6%,特异度87.5%,p-tau 无诊断意义;(6)S-100B 蛋白≥1.626 ng/ml 为阈值点,敏感度为92.3%,特异度为83.8%;(7)14-3-3蛋白以≥9 ng/ml 为阈值点,敏感度为86.7%,特异度为86.4%;(8)14-3-2蛋白以≥24 ng/ml 为阈值点,其敏感度为78.6%,特异度为77.3%。结论脑脊液神经蛋白质检测对散发性 Creutzfeldt-Jakob病的早期诊断有一定价值。
Objective To investigate and compare the early diagnostic value of several neuroproteins in Creutzfeldt-Jakob disease (CJD). Methods Cerebrospinal fluid (CSF) was collected from 14 patients with CJD within two months after onset. Protein t-tau, p-tau, t-tau and p-tau (T-tau / p-tau), S-100β protein, 14-3-3 protein and 14-3-2 protein were detected quantitatively, and at the same time, non-CJD dementia , 18 cases) control group. Results (1) t-tau protein: CJD group, OD group and ND group were 8295,300,161 pg / ml respectively. The p-tau / t-tau values were 0.0092, 0.2258 and 0.2471, respectively. (2) S-100β protein: CJD group, OD group, ND group were 1.576,0.639,0.239 ng / ml. (3) 14-3-3 protein: CJD group, OD group, ND group were 40.00,2.65,3.10 ng / ml respectively. (4) 14-3-2 protein: CJD group, OD group and ND group were 48.43,14.00,20.50 ng / ml respectively. (5) The t-tau≥500 pg / ml was the threshold point, the sensitivity was 84.6% and the specificity was 87.5%, p-tau had no diagnostic value. (6) S-100B protein≥1.626 ng / ml was the threshold point, The specificity and specificity of the 14-3-3 protein were 92.3% and 83.8% respectively. (7) The sensitivity and specificity of 14-3-3 protein were 86.7% and 86.4% Protein with a threshold of ≥24 ng / ml had a sensitivity of 78.6% and a specificity of 77.3%. Conclusion Detection of cerebrospinal fluid neuroproteins is of value in the early diagnosis of sporadic Creutzfeldt-Jakob disease.