基于"髓空痰浊"病机理论探讨外周免疫与阿尔茨海默病痴呆的相关性OA

Objective It is to explore the correlation between peripheral immunity and the progression of dementia in Alzheimer's disease(AD)based on the theory of"marrow emptying and phlegm turbidity"in traditional Chinese medi-cine.Methods A total of 90 AD patients(45 with syndrome of medullary insufficiency and 45 with syndrome of phlegm-turbidity clouding the spirit)treated in Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January to December 2023,and 30 healthy controls underwent health checkups during the same period(healthy con-trol group)were enrolled as the study subjects.the the general information,Mini-Mental State Examination(MMSE)scores,Montreal Cognitive Assessment(MoCA)scores,Activities of Daily Living(ADL)scores,and levels of CD4+,CD8+,CD4+/CD8+ratio,regulatory T cells(Treg),and helper T cells(Th)1,Th2,and Th17 in peripheral blood were compared among the three groups.The peripheral blood immune indicators and scale scores of patients in the group of medullary insufficiency and group of phlegm-turbidity clouding the spirit were respectively analyzed with Pearson correlation analysis;it was syndrome of phlegm-turbidity clouding the spirit or not as the dependent variables and were analyzed with binary Logistic regression analysis;the immune indicators with statistically significant differences between groups were as-sessed with individual and combined ROC curves.Results There were no statistically significant differences in gender,years of education,body mass index,MoCA scores and ADL scores among the three groups(all P>0.05);the MMSE scores of patients in the group of medullary insufficiency and group of phlegm-turbidity clouding the spirit were obviously lower than those in the healthy control group(all P<0.05),but there was no statistically significant difference between the group of medullary insufficiency and group of phlegm-turbidity clouding the spirit(P>0.05);the patients in the group of phlegm-turbidity clouding the spirit were significantly older than those in the group of medullary insufficiency and healthy control group(all P<0.05).The level of CD4+and CD4+/CD8+in the group of phlegm-turbidity clouding the spirit were signif-icantly higher than those in the healthy control group and group of medullary insufficiency(all P<0.05);the level of Th2 in the group of phlegm-turbidity clouding the spirit was significantly higher than that in the group of medullary insufficiency(P<0.05).The immune indicators were not significantly correlated with MMSE,MoCA,or ADL scores in the group of medullary insufficiency(all P>0.05);the level of Th1 was negatively correlated with MMSE scores(r=0.404,P=0.006)and MoCA scores(r=0.387,P=0.009),and ADL scores were positively correlated with Th1 levels(r=0.296,P=0.048)and level of CD4+(r=0.317,P=0.034).It was syndrome of phlegm-turbidity clouding the spirit or not as the dependent variables,binary Logistic regression analysis showed that CD4+(OR=1.099,95%CI:1.034-1.168)and CD4+/CD8+(OR=2.185,95%CI:1.103-4.331)were risk factors for the onset of dementia in AD patients with syn-drome of phlegm-turbidity clouding the spirit;the area under the curve(AUC)of CD4+and CD4+/CD8+as individual predictors were 0.705 and 0.631,respectively,while the AUC for the combined prediction of CD4+,CD8+,and CD4+/CD8+was 0.736;the combined predictive performance was superior to that of individual indicators(Z=2.014,P=0.044).Conclusion The progression from"marrow-void"to"phlegm-turbid"stage in AD correlates with peripheral im-mune changes,and combination of CD4+,CD8+,and CD4+/CD8+has predictive value for the course and prognosis of AD.