Division of Neurology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Division of Neurology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
J Neurol Sci. 2019 Jan 15;396:48-51. doi: 10.1016/j.jns.2018.10.033. Epub 2018 Nov 3.
The cerebrospinal fluid total protein level (CSF-TP) is commonly used as a potential marker of infectious or immune disease of the CNS and PNS. Recent laboratory reference studies indicate that the antiquated single upper reference limit of 0.45 g/L commonly used by hospital laboratories and widely quoted in medical literature is a significant underestimation.
We distributed worldwide a web-based survey comprised of three questions: 1. What is the CSF-TP upper limit used at your institution? 2. What is the source of this upper limit? 3. Do you adjust your upper limit according to age?
A total of 473 unique responses were obtained from North America (37.5%), South America (5.5%), Europe (29.4%), Africa (4%), Asia (21.6%) and Oceania (1.7%). A strong preponderance (86.8%) of institutions reported an upper limit of 0.45 g/L or less. Only 4% reported making age-partitioned adjustments.
Worldwide, a strong majority of hospital laboratories presently use an underestimation of CSF-TP upper reference value, particularly for older adults. Recent well powered laboratory reference studies support higher values with age adjustment.
脑脊液总蛋白水平（CSF-TP）通常被用作中枢神经系统和周围神经系统感染或免疫疾病的潜在标志物。最近的实验室参考研究表明，医院实验室常用的陈旧的单一上参考限值 0.45g/L 被广泛引用，但被严重低估。
我们在全球范围内分发了一个基于网络的调查，其中包含三个问题：1. 贵机构使用的 CSF-TP 上限是多少？2. 这个上限的来源是什么？3. 你是否根据年龄调整上限？
共收到来自北美（37.5%）、南美（5.5%）、欧洲（29.4%）、非洲（4%）、亚洲（21.6%）和大洋洲（1.7%）的 473 个独特回复。绝大多数机构（86.8%）报告的上限为 0.45g/L 或更低。只有 4%的机构报告进行了年龄分段调整。
目前，全球绝大多数医院实验室都在使用 CSF-TP 上参考值的低估值，尤其是对于老年人。最近的、具有充分统计学效力的实验室参考研究支持随着年龄调整而提高上限值。
