血清AGEs、sRAGE、SOD、MDA对血管性痴呆的辅助诊断价值

卢军锋 方芳

[摘要] 目的 探討血清AGEs、sRAGE、SOD、MDA对血管性痴呆的辅助诊断价值。 方法 选择2018年6月～2019年9月在我院诊断治疗的血管性痴呆患者30例为研究对象，另选择健康体检者30例为对照组。比较两组血清AGEs、sRAGE、SOD、MDA水平。绘制ROC曲线，用曲线下面积判断AGEs、sRAGE、SOD、MDA对血管性痴呆的辅助诊断价值。 结果 （1）血管性痴呆组SOD活性显著低于对照组，MDA水平显著高于对照组，差异有统计学意义（P<0.05）;两组血清AGEs、sRAGE水平比较无统计学差异（P>0.05）。（2）AGEs对血管性痴呆的辅助诊断价值ROC曲线下面积AUC 0.490，无辅助诊断价值。（3）sRAGE对血管性痴呆的辅助诊断ROC曲线下面积AUC=0.508，无辅助诊断价值。（4）SOD活性对血管性痴呆的辅助诊断ROC曲线下面积AUC=0.833，具有较好的辅助诊断价值。以65.0 nU/mL为界值，灵敏度73.3%，特异度96.7%。（5）MDA对血管性痴呆的辅助诊断价值ROC曲线下面积0.905，具有较好的辅助诊断价值。以7.0 mol/mL为界值，灵敏度85.0%，特异度90.0%。 结论 血清AGEs、sRAGE水平对血管性痴呆无明确的辅助诊断价值，而SOD与MDA对血管性痴呆有一定的辅助诊断价值。

[关键词] 晚期糖基化终末产物;可溶性晚期糖基化终末产物特异性受体;超氧化物歧化酶;血管性痴呆;辅助诊断

[中图分类号] R749.1          [文献标识码] A          [文章编号] 1673-9701（2020）15-0018-04

Auxiliary diagnostic value of serum AGEs， sRAGE， SOD， MDA in vascular dementia

LU Junfeng1   FANG Fang2

1.Department of Emergency，Hangzhou Traditional Chinese Medicine Hospital，Hangzhou 310007，China;2.Department of Neurology，Hangzhou Traditional Chinese Medicine Hospital，Hangzhou 310007，China

[Abstract] Objective To explore the auxiliary diagnostic value of serum advanced glycation end products（AGEs）， soluble receptor for advanced glycation end products（sRAGE）， superoxide dismutase（SOD）， and multiple ascending dose（MDA） in the vascular dementia. Methods 30 patients with vascular dementia diagnosed and treated in our hospital from June 2018 to September 2019 were selected as the study subjects，and 30 healthy people were selected as the control group. The serum AGEs， sRAGE， SOD， and MDA levels were compared between the two groups. The ROC curve was drawn， and the area under the curve was used to determine the auxiliary diagnostic value of AGEs， sRAGE， SOD， and MDA in vascular dementia. Results（1）The SOD activity in the vascular dementia group was significantly lower than that in the control group， and the MDA level was significantly higher than that in the control group， and the differences were statistically significant（P<0.05）. There were no significant differences in serum AGEs and sRAGE between the two groups（P>0.05）. （2）The area under the ROC curve（AUC） of AGEs for the auxiliary diagnosis of vascular dementia was 0.490，which had no auxiliary diagnostic value. （3）The AUC of sRAGE for the auxiliary diagnosis of vascular dementia was 0.508， which had no auxiliary diagnostic value. （4）The AUC of SOD activity for the auxiliary diagnosis of vascular dementia was 0.833， which had good auxiliary diagnostic value. Taking 65.0 nU/mL as the cut-off value， the sensitivity was 73.3% and the specificity was 96.7%. （5）The AUC of MDA for the auxiliary diagnosis of vascular dementia was 0.905，which had good auxiliary diagnostic value. Taking 7.0 mol/mL as the cut-off value，the sensitivity was 85.0% and the specificity was 90.0%. Conclusion Serum AGEs and sRAGE levels have no clear auxiliary diagnostic value for vascular dementia，while SOD and MDA have certain auxiliary diagnostic value for vascular dementia.

[Key words] Advanced glycation end products; Soluble receptor for advanced glycation end products; Superoxide dismutase; Vascular dementia; Auxiliary diagnosis

血管性痴呆是脑血管疾病临床类型中的一种，也是脑血管疾病临床转归的一种类型。脑血管疾病是指某一区域脑组织暂时或永久缺血或出血和（或）某一病理过程主要损害脑的一个或数个血管的所有病变。血管性痴呆是由脑血管疾病引起的，以痴呆为主要临床表现的脑功能衰退性疾病[1，2]。晚期糖基化终末产物（Advanced glycation end products，AGEs）是过量的糖和蛋白质结合的产物，目前的研究显示，AGEs可加速人体衰老，与多种慢性退化型疾病的发生有关[3，4]。……