Department of Laboratory Diagnosis, Changhai Hospital, Second Military Medical University , Shanghai.
Scand J Clin Lab Invest. 2013 Dec;73(8):601-6. doi: 10.3109/00365513.2013.830326. Epub 2013 Nov 7.
We performed a systematic review of English-language studies published during the past three decades to investigate the diagnostic performance of serum glial fibrillary acidic protein (GFAP) for the differential diagnosis of acute stroke, including intracerebral hemorrhage (ICH) and cerebral ischemia (CI). QUADAS tools were used to evaluate the quality of the study. Performance characteristics (diagnostic sensitivity, specificity, and other measures of accuracy) were pooled and examined using fixed-effects models. Four studies met the inclusion criteria, and included 109 patients with ICH and 381 patients with CI. The summary estimates for GFAP in the ICH diagnoses had a diagnostic sensitivity of 0.80 (95% confidence interval 0.71-0.88), a specificity of 0.97 (95% confidence interval, 0.94-0.98), and a diagnostic odds ratio (DOR) of 119.55 (95% confidence interval: 51.75-276.19). The area under curve (AUC) and Q value for the sROC curves were 0.97 and 0.92, respectively. Therefore, GFAP showed high diagnostic accuracy for acute stroke differential diagnosis.
我们对过去三十年发表的英文研究进行了系统评价，以调查血清神经胶质纤维酸性蛋白（GFAP）在急性脑卒中（包括脑出血[ICH]和脑缺血[CI]）鉴别诊断中的诊断性能。使用 QUADAS 工具评估研究质量。使用固定效应模型汇总和检查性能特征（诊断敏感性、特异性和其他准确性度量）。四项研究符合纳入标准，包括 109 例 ICH 患者和 381 例 CI 患者。ICH 诊断中 GFAP 的汇总估计值的诊断敏感性为 0.80（95%置信区间 0.71-0.88），特异性为 0.97（95%置信区间 0.94-0.98），诊断比值比（DOR）为 119.55（95%置信区间：51.75-276.19）。sROC 曲线的曲线下面积（AUC）和 Q 值分别为 0.97 和 0.92。因此，GFAP 对急性脑卒中的鉴别诊断具有较高的诊断准确性。
