嗅觉特征联合认知测试在轻度认知功能障碍诊断中的应用价值
Combination of olfactory features with cognitive testing in diagnosis of mild cognitive impairment
霍雅欣 1王岚 2梁维 1耿皓 1敬欣阳 1王雪萌 1黄桉琦 1于哲 1安翠霞2
作者信息
- 1. 河北医科大学第一医院精神卫生中心(石家庄 050031)
- 2. 河北医科大学第一医院精神卫生中心(石家庄 050031);河北省精神心理疾病临床医学研究中心
- 折叠
摘要
目的 探讨嗅觉特征联合认知测试在轻度认知功能障碍(mild cognitive impairment,MCI)诊断中的应用价值.方法 2021年4月至2022年4月在石家庄市及邢台市社区老年人中纳入经量表评定存在MCI者(MCI组)70名,以及认知功能正常(normal cognitive,NC)者(NC组)236名.对受试者进行嗅觉识别功能检测、联合波士顿命名测试(Boston naming test,BNT),并采血检测血液生物标志物β淀粉样蛋白40(amyloid β-protein 40,Aβ40)、Aβ42、磷酸化tau蛋白217(phosphorylated tau 217,p-tau217),设定单独嗅觉特征、嗅觉特征联合BNT、嗅觉特征联合血液Aβ40、BNT联合血液Aβ40共4种MCI筛查方案,通过受试者操作特征(receiver operating characteristic,ROC)曲线分析各个方案对MCI识别的敏感度及特异度.结果 单独嗅觉特征识别MCI的敏感度为61.7%、特异度为80.0%,曲线下面积(area under the curve,AUC)为0.727;嗅觉特征联合BNT识别MCI的敏感度为75.0%、特异度为73.8%,AUC为0.788;嗅觉特征联合血液Aβ40识别MCI的敏感度为51.6%、特异度为83.5%,AUC为0.709;BNT联合血液Aβ40识别MCI的敏感度为61.1%、特异度为84.6%,此时AUC为0.770.结论 对于社区可疑MCI的筛查采用嗅觉特征结合BNT的方法可提高敏感度和特异度,BNT结合血液Aβ40也可以提高识别MCI的特异度.
Abstract
Objective To explore the value of olfactory features combined with cognitive testing in the diagnosis of mild cognitive impairment(MCI).Methods From April 2021 to April 2022,70 MCI patients(MCI group)and 236 normal cognitive(NC)controls(NC group)were included from the elderly in Shijiazhuang and Xingtai communities.Subjects were tested for the olfactory recognition function,combined with the Boston naming test(BNT),and venipunctured for blood biomarkers β amyloid protein 40(Aβ40),Aβ42 and phosphorylated tau 217(p-tau217).The four MCI screening programs,including olfactory features,BNT with olfactory features,olfactory features with blood Aβ40,and BNT with blood Aβ40 were set as screening schemes.The accuracy sensitivity and specificity of MCI recognition were analyzed by receiver operating characteristic(ROC)curve.Results The sensitivity of olfactory feature alone was 61.7%,the specificity was 80.0%,and the area under the curve(AUC)was 0.727.The sensitivity of olfactory features with BNT was 75.0%,specificity was 73.8%,and AUC was 0.788.The olfactory feature combined with blood biomarker Aβ40 had a sensitivity of 51.6%and specificity of 83.5%in identifying MCI,and AUC was 0.709.The BNT combined with blood biomarker Aβ40 had a sensitivity of 61.1%and specificity of 84.6%in identifying MCI,and AUC was 0.770.Conclusion For the screening of suspected MCI in the community,olfactory features combined with BNT can improve the sensitivity and specificity,and BNT combined with blood Aβ40 can also improve the specificity of MCI recognition.
关键词
老年人/轻度认知功能障碍/嗅觉识别功能/认知测试/血液生物标志物Key words
Aged/Mild cognitive impairment/Olfactory recognition function/Cognitive testing/Blood biomarkers引用本文复制引用
基金项目
中央引导地方项目(2019)(199477138G)
河北省省级科技计划(SG2021189)
河北省自然科学基金(H2022206544)
出版年
2024
NETL
NSTL
维普
万方数据