尿液β-淀粉样蛋白检测试剂盒筛查认知下降风险在中国多家医院和社区的真实世界应用表现OA
Real-world performance of urine β-amyloid test kit in multiple hospital clinics and neighborhood communities of China
目的:探讨尿液 β-淀粉样蛋白检测试剂盒筛查认知下降风险在中国多家医院和社区的真实世界应用表现.方法:本研究在长沙 5 家医院开展了随机社区筛查,进行了多中心病例对照研究.社区筛查人口51 187 人.多中心病例对照研究共纳入 898 名受试者,包括 266 名无任何合并疾病的健康年龄匹配对照组、167 例轻度认知障碍/阿尔茨海默病(MCI/AD)患者组和 465 例共患其他疾病症状患者组和年龄相关疾病的非 AD 患者组.结果:尿液 AβPP 检测在社区人口中,男性和女性均显示出明显的年龄依赖性阳性率,从 6.29%增至 15.40%.健康组、非 AD 组和 MCI/AD 组的弱阳性/阳性/阴性人数分别为 8/12/246(阳性率 7.52%)、41/16/409(12.23%)和 77/44/46(72.46%),Kappa 值为 0.669,表明该方法在 MCI/AD的临床诊断中表现良好,与先前发表的研究结果一致.8名弱阳性的健康受试者中,有6名经MRI/CT检查发现脑部异常.基于试剂盒结果的合并疾病/症状关联分析显示,记忆力下降是认知下降最显著的危险因素(P=9.6×10-23,Fisher精确检验),其次是高脂血症(P=3.2×10-¹²)、卒中史(P=0.0011)和高血压(P=0.0058).基于试剂盒的治疗效果分析显示,心血管疾病药物和抗血栓药物显著降低了认知下降关联(P 值分别为 0.0061 和 0.0081),其次是降血糖药物(P=0.0358).而对于AD患者,仅接受美金刚治疗的患者检测阳性率略有降低(P=0.0532).结论:尿液AβPP 检测在MCI和AD 相关认知下降中的辅助诊断和一线筛查工具的价值,探索了尿液 AβPP 与老年人常见症状疾病的关联性,为尿液 AβPP 用于筛查早期有认知障碍风险的老年人,特别是早期老年痴呆患者的精准筛查提供了重要的依据.
Objective:To explore the real-world application performance of the urine β-amyloid protein detection kit in screening the risk of cognitive decline in multiple hospitals and communities in China.Methods:In this study,the clinical values of One-Step Dementia Risk Test Kit in early screening were further validated by community health screening in Changsha(n=51 187)and a multi-center,case-control study with a total of 898 participants including 266 healthy age-matched controls,167 MCI/AD patients and 465 non-AD patients with various comorbidities and age-related diseases.Results:The number of weak positive/positive/negative in the healthy,non-AD and MCI/AD group was 8/12/246(positivity 7.52%),41/16/409(12.23%)and 77/44/46(72.46%),respectively,resulting in a Kappa value of 0.669 which indicated a good diagnostic performance.Comorbidity analysis identified memory decline as the most significant risk factor(P=9.6×10-23,Fisher's Exact Test),followed by hyperlipidemia(P=3.2×10-12),history of stroke(P=0.0011)and hypertension(P=0.00058).Therapeutics analysis showed medications for cardiovascular diseases and anti-thrombosis significantly reduced risk of dementia(P=0.0061 and 0.0081,respectively).For AD patients,only patients receiving memantine treatment showed a slight reduction in kit positivity(P=0.0532).The kit also showed a clear age-dependent increase of positivity from 6.29%-15.40%,in health screening.Conclusions:Our results confirmed the diagnostic value of the kit in MCI and AD-dementia.Moreover,the kit can be used in the real world to assess the risk of various conditions towards AD as well as the treatment efficacy.
乔立艳;脱厚珍;王诗雅;向光红;周妮娜;林勇;王军;王虹峥;王桂红;陈小童;王静;黄微;邢冬梅;赵庆芳;王运良;尹红蕾
清华大学玉泉医院,北京 100049首都医科大学附属北京友谊医院,北京 100050首都医科大学附属北京友谊医院,北京 100050湖南省第二人民医院,湖南 长沙 410007湖南省第二人民医院,湖南 长沙 410007上海市静安区中心医院,上海 200040||国家老年疾病临床医学研究中心(华山),上海 200032北京交通大学生命科学与生物工程研究院,北京 100044北京协和医学院,北京 100006首都医科大学附属北京天坛医院,北京 100070上海市静安区中心医院,上海 200040清华大学玉泉医院,北京 100049云南省第三人民医院,云南 昆明 650011云南省第三人民医院,云南 昆明 650011云南省第三人民医院,云南 昆明 650011中国融通医疗健康集团淄博一四八医院,山东 淄博 255300中国融通医疗健康集团淄博一四八医院,山东 淄博 255300
医药卫生
尿液β-淀粉样蛋白试剂盒认知早筛共生病
Urine β-amyloidKitCognitionEarly screenComorbidity
《阿尔茨海默病及相关病》 2026 (3)
150-157,172,9
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