Meta 分析确定肿瘤坏死因子-α和白细胞介素-1β为细菌性和无菌性脑膜炎的诊断生物标志物。

Meta-analysis identifies tumor necrosis factor-alpha and interleukin-1 beta as diagnostic biomarkers for bacterial and aseptic meningitis.

机构信息

Rua Cruz e Souza, 510, Bairro Pio Correa- CEP 88811-550, Criciúma-SC- Brazil.

出版信息

Curr Neurovasc Res. 2014;11(4):340-8. doi: 10.2174/1567202611666140912120940.

DOI:10.2174/1567202611666140912120940

PMID:25219657

Abstract

BACKGROUND

Meningitis is a complex and severe acute infectious disease of the central nervous system and is caused mainly by bacteria and viruses. However, the distinction between aseptic and bacterial meningitis can be difficult for clinicians because the symptoms and the results of laboratory assays are often similar and overlapping, particularly when the use of antibiotics is administered prior to examining the cerebrospinal fluid.

METHODS

We determined the accuracy of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) for the differential diagnosis between bacterial and aseptic meningitis. A comprehensive search was performed for papers published from January 1989 to July 2013. Prospective or retrospective studies and cerebrospinal fluid (CSF) TNF-α and/or IL-1β cytokine concentrations for differential diagnosis distinguishing bacterial from aseptic meningitis were included.

RESULTS

A statistical analysis was performed using Revman and Meta-Disc. This systematic review showed that TNF-α has a sensitivity of 80.5%, specificity of 94.9%, diagnostic odds ratio (DOR) of 71.7, and area under the curve (AUC) = 0.942; IL-1β showed a sensitivity of 86.0%, specificity of 92.3%, DOR of 53.5, and AUC = 0.975.

CONCLUSION

Therefore, TNF-α and IL-1β are useful markers for the prediction of the bacterial meningitis and levels may represent an accurate method that is useful for the differentiation between bacterial and aseptic meningitis.

摘要

背景

脑膜炎是一种复杂而严重的中枢神经系统急性传染病，主要由细菌和病毒引起。然而，由于症状和实验室检测结果往往相似且重叠，特别是在使用抗生素之前检查脑脊液时，临床医生很难区分无菌性和细菌性脑膜炎。

方法

我们确定肿瘤坏死因子-α（TNF-α）和白细胞介素-1β（IL-1β）在细菌性和无菌性脑膜炎鉴别诊断中的准确性。从 1989 年 1 月到 2013 年 7 月，我们对发表的文献进行了全面搜索。纳入了前瞻性或回顾性研究，以及用于区分细菌性和无菌性脑膜炎的脑脊液（CSF）TNF-α和/或 IL-1β细胞因子浓度的差异诊断。

结果

使用 Revman 和 Meta-Disc 进行了统计分析。这项系统评价表明，TNF-α 的敏感性为 80.5%，特异性为 94.9%，诊断比值比（DOR）为 71.7，曲线下面积（AUC）=0.942；IL-1β 的敏感性为 86.0%，特异性为 92.3%，DOR 为 53.5，AUC=0.975。