Meta分析评估肌萎缩侧索硬化患者磷酸化神经丝蛋白的临床诊断价值

Increasing Phosphorylated Neurofilament Heavy Chain in Amyotrophic Lateral Sclerosis:a Meta-analysis

目的:评估磷酸化神经丝重链(pNfH)在ALS患者脑脊液(CSF)中的临床诊断价值。方法:采用关键词"Neurofilament","Neurofilament light chain","Neurofilament heavy chain"and"Amyotrophic lateral sclerosis"对"PubMed","Springer"和"Medline"数据库进行检索,时间限定为至2017年1月。运用亚组分析和Meta回归探讨异质性。结果:共纳入7篇文献,涉及780名参与者。ALS患者CSF pNfH水平高于非ALS疾病组(Pooled Std.MD=1.72;95%CI:[1.12,2.32],P<0.00001)。人口变异,pNfH检测技术,样本量,ALS患者CSF神经丝蛋白轻链水平是纳入研究间的主要异质性来源。CSF pNfH在诊断ALS时有较高的敏感性和特异性。结论:ALS患者CSF中pNfH明显增加,但各项研究间存在多种异质性来源。在鉴别ALS和健康者或非ALS疾病时,CSF pNfH存在重要的临床价值。

Objective:Estimate the role of cerebrospinal fluid(CSF)phosphorylated neurofilament heavy chain(pNfH)in amyotrophic lateral sclerosis(ALS)patients.Method:Combined terms,such as,"Neurofilament","Neurofilament light chain","Neurofilament heavy chain"and"Amyotrophic lateraland standard mean difference(Std.MD)was calculated.Results:A total of 7 studies were pooled,in which 780 participants were involved.The CSF pNfH levels in ALS patients are higher than that in healthy or disease controls(pooled Std.MD=1.72;95% CI:1.12~2.32,P<0.00001).Moreover,population variations,detection technique,sample size,characteristics of controls,and neurofilament light chain(NFL)levels in CSF contributed to the heterogeneity sources.Conclusion:CSF levels of pNfH increases in ALS patients.There was an important role of CSF pNfH in distinguishing ALS from healthy or disease controls.