血清SV2A、Aβ42、Tau蛋白、p-Tau181水平对阿尔茨海默病诊断及病情评估的价值研究OA

Objective To explore the value of serum synaptic vesicle protein 2A(SV2A)level in the diagnosis and condition assessment of Alzheimer's disease(AD).Methods A total of 130 AD patients(60 cases of mild,40 cases of mod-erate and 30 cases of severe)who visited the Department of Neurology of the 904th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from January 2021 to December 2023 and 20 healthy controls were included.The levels of serum SV2A,Aβ42,Tau protein and p-Tau181 were detected by enzyme-linked immunosorbent assay(ELISA).The correlations were analyzed in combination with cognitive function scales(MMSE,MoCA),disease severity scales(CDR,ADL,NPI)and hippocampal volume.The diagnostic efficacy of SV2A was evaluated by ROC curve.Multiple linear regres-sion is used to screen for independent influencing factors.Results Compared with the healthy control group,the levels of se-rum SV2A and A β4 2 in the AD group decreased,but the levels of Tau protein and p-Tau181 increased in the AD group(t/P=12.682/＜0.001,10.875/＜0.001,15.923/＜0.001,20.341/＜0.001).In the AD group,the levels of serum SV2A and Aβ42 in patients with mild,moderate and severe AD decreased successively,but the levels of Tau protein and p-Tau181 increased successively(F/P=56.789/＜0.001,32.145/＜0.001,45.670/＜0.001,68.912/＜0.001).The serum SV2A level showed a decreasing trend with the aggravation of AD severity(150.45±15.87 ng/mL in the healthy control group vs 80.78±13.45 ng/mL in the severe AD group,P＜0.001),which was significantly positively correlated with MMSE and MoCA scores(r=0.652,0.625,both P＜0.001),and negatively correlated with CDR,ADL,NPI scores and disease course(r=-0.721 to-0.552,all P＜0.001),and was positively correlated with hippocampal volume(r=0.502,P＜0.001).Serum SV2A level(OR=0.821,95％CI.0.756-0.889,P＜0.001),age(OR=1.123,95％CI:1.087-1.160,P＜0.001),MMSE score(OR=0.895,95％CI:0.856-0.934,P＜0.001),ADL score(OR=1.056,95％CI:1.023-1.089,P＜0.001),and hippocampal volume(OR=0.912,95％CI:0.876-0.948,P＜0.001)were independ-ent risk factors for the progression of AD.The ROC curve further demonstrated that the AUC for predicting the prevalence of AD by combining serum SV2A level,age,MMSE score,ADL score and hippocampal volume increased to 0.905(95％CI:0.856-0.954,P＜0.001),which was significantly higher than that of a single indicator(P＜0.001).Conclusion The level of se-rum SV2A is closely related to the severity of AD and cognitive function,and has high efficacy in the diagnosis of AD.It can be used as a potential biomarker for auxiliary diagnosis and disease assessment.