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创伤性脑损伤后 copeptin 的预后作用:观察性研究的系统评价和荟萃分析

Prognostic role of copeptin after traumatic brain injury: A systematic review and meta-analysis of observational studies.

作者信息

Choi Kyu-Sun, Cho Youngsuk, Jang Bo-Hyoung, Kim Wonhee, Ahn Chiwon, Lim Tae Ho, Yi Hyoung-Joong

机构信息

Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.

Department of Emergency Medicine, College of Medicine, Hallym University, Seoul, Republic of Korea; Department of Biomedical Engineering, College of Medicine, Hanyang University, Republic of Korea.

出版信息

Am J Emerg Med. 2017 Oct;35(10):1444-1450. doi: 10.1016/j.ajem.2017.04.038. Epub 2017 Apr 19.

Abstract

PURPOSE

Copeptin, the C-terminal portion of provasopressin, has emerged as a novel prognostic marker in neurocritical care, such as in traumatic brain injury (TBI). The aim of this study was to quantitatively assess the prognostic significance of initial plasma copeptin levels in the neurological outcome and mortality after traumatic brain injury.

MATERIALS AND METHODS

Six relevant studies with data from 552 patients were included in this meta-analysis.

RESULTS

The plasma copeptin levels were found to be significantly higher in patients who died than in the survivors (standardized mean difference [SMD], 1.80). In the four studies reporting Glasgow outcome scale (GOS) data, patients with unfavorable outcomes had significantly higher copeptin levels than those with favorable outcomes (SMD, 1.62). The plasma copeptin level predicted mortality and unfavorable outcomes (AUC, 0.873; AUC, 0.876).

CONCLUSIONS

The present meta-analysis suggests that early measurement of plasma copeptin levels can provide better prognostic information about the functional outcome and mortality in patients with TBI.

摘要

目的

copeptin,即加压素原的C末端部分,已成为神经重症监护领域(如创伤性脑损伤(TBI))中的一种新型预后标志物。本研究的目的是定量评估创伤性脑损伤后初始血浆copeptin水平对神经功能结局和死亡率的预后意义。

材料与方法

本荟萃分析纳入了6项涉及552例患者数据的相关研究。

结果

发现死亡患者的血浆copeptin水平显著高于存活患者(标准化均数差[SMD],1.80)。在4项报告格拉斯哥预后量表(GOS)数据的研究中,预后不良的患者copeptin水平显著高于预后良好的患者(SMD,1.62)。血浆copeptin水平可预测死亡率和不良结局(AUC,0.873;AUC,0.876)。

结论

本荟萃分析表明,早期检测血浆copeptin水平可为创伤性脑损伤患者的功能结局和死亡率提供更好的预后信息。

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