脑脊液tau蛋白预测阿尔茨海默病的Meta分析

Clinical value of tau protein in cerebrospinal fluid for prediction of Alzheimer′s disease: a Meta-analysis

目的评价脑脊液(CSF)总tau蛋白(t-tau)和磷酸化tau蛋白(p-tau)浓度预测阿尔茨海默病(Alzheimer's disease,AD)的有效性和准确性。方法全面检索tau蛋白浓度预测轻度认知功能障碍(mild cognitive impairment,MCI)转化为AD的诊断性试验文献,评价纳入文献的质量,用Review Manager 5.1和Meta Disk 1.4软件进行Meta分析,计算合并效应量。结果共纳入15项研究,MCI进展为AD的t-tau基线浓度(pg/mL)高于对照组[加权均数差(WMD):320.7;95%CI:274.2～367.3],p-tau基线浓度(pg/mL)亦高于对照组(WMD:32.8;95%CI:29.5～36.0)。t-tau预测AD的诊断优势比(diagnostic odds ration,DOR)为14.1(95%CI:8.2～24.4);p-tau的DOR为22.4(95%CI:10.4～48.3)。结论 CSF中tau蛋白可作为预测AD发生的重要指标。

Objective To evaluate the efficiency and accuracy of total tau（t-tau） and phosphorylated tau（p-tau） proteins in cerebrospinal fluid（CSF） as biomarkers for predicting Alzheimer′s disease（AD）.Methods The published clinical literatures which aimed to investigate the concentration of tau protein to predict the conversion of mild cognitive impairment（MCI） to AD were retrieved.The quality of all the included literatures was assessed.Meta-analysis was carried out by the software Review Manager 5.1 and Meta Disk 1.4.Results Fifteen literatures that met the inclusion criteria were included in this study.The baseline concentrations（pg/mL） of both t-tau and p-tau in MCI to AD patients were higher than those in control group.The weighted mean difference（WMD） of t-tau in MCI to AD patients was 320.7,95%CI： 274.2-367.3,and WMD of p-tau was 32.8,95%CI： 29.5-36.0）.Overall diagnostic odds ratios（DOR） of t-tau and p-tau were 14.1（95%CI： 8.2-24.4） and 22.4（95%CI： 10.4-48.3） respectively.Conclusion Tau in CSF may be an important diagnostic marker for predicting AD.