更新的脑脊液总蛋白参考值可改善慢性炎症性脱髓鞘性多发性神经病的诊断。
Updated cerebrospinal fluid total protein reference values improve chronic inflammatory demyelinating polyneuropathy diagnosis.
机构信息
Department of Medicine, Division of Neurology, The Ottawa Hospital, University of Ottawa, 1053 Carling Ave, Room ES-08, Ottawa, M5G 2C4, Ontario, Canada.
Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
出版信息
Muscle Nerve. 2019 Aug;60(2):180-183. doi: 10.1002/mus.26488. Epub 2019 May 17.
INTRODUCTION
Recent literature has concluded that cerebrospinal fluid total protein (CSF-TP) upper reference limits (URL) should be higher than 45 mg/dl and stratified by age.
METHODS
Data-driven URLs were applied to the analysis of a cohort of patients with correctly and incorrectly diagnosed chronic inflammatory demyelinating polyneuropathy (CIDP). Descriptive statistics were calculated, and exploratory analyses were used to test the impact of different CSF-TP URLs on sensitivity and specificity of CIDP diagnosis.
RESULTS
The adoption of higher and age-dependent CSF-TP URLs reduced the sensitivity of CSF analysis slightly (from 95% to 84%-86%); however, the overall CIDP detection rate was unchanged. Twelve of 36 (33%) false-positive diagnoses occurred with CSF-TP elevation as the sole supportive criteria. By applying updated CSF-TP URLs, the specificity of CSF analysis increased from 39% to 57%-64%.
DISCUSSION
Implementation of data-driven CSF-TP URLs improves CIDP diagnostic specificity without compromising sensitivity, thereby lessening CIDP misdiagnosis. Muscle Nerve 60: 180-183, 2019.
简介
最近的文献得出结论，脑脊液总蛋白（CSF-TP）的上参考限值（URL）应高于 45mg/dl，并按年龄分层。
方法
将数据驱动的 URL 应用于一组正确和不正确诊断的慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的分析。计算描述性统计数据，并进行探索性分析以测试不同 CSF-TP URL 对 CIDP 诊断敏感性和特异性的影响。
结果
采用更高和年龄依赖性的 CSF-TP URL 略微降低了 CSF 分析的敏感性（从 95%降至 84%-86%）；然而，总体 CIDP 检出率保持不变。12 例（33%）假阳性诊断仅因 CSF-TP 升高而发生。通过应用更新的 CSF-TP URL，CSF 分析的特异性从 39%提高到 57%-64%。
讨论
实施数据驱动的 CSF-TP URL 可提高 CIDP 诊断的特异性而不影响敏感性，从而减少 CIDP 的误诊。肌肉神经 60: 180-183, 2019.
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