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神经丝轻链蛋白在神经退行性痴呆中的研究:系统评价和网络荟萃分析。

Neurofilament light chain protein in neurodegenerative dementia: A systematic review and network meta-analysis.

机构信息

Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China.

Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China.

出版信息

Neurosci Biobehav Rev. 2019 Jul;102:123-138. doi: 10.1016/j.neubiorev.2019.04.014. Epub 2019 Apr 24.

Abstract

The diagnostic value of neurofilament light chain protein in neurodegenerative dementia diseases is still controversial. A systematic literature search was performed to identify relevant case-control studies conducted through October 2018. Traditional and net meta-analyses were performed based on 42 studies that tested the diagnostic performance of neurofilament light chain protein (NfL) concentration in CSF and serum/plasma from patients with neurodegenerative dementia. CSF and serum/plasma NfL levels were significantly increased in patients with neurodegenerative dementia diseases. Network meta-analysis showed a significant reduction in CSF NfL levels during mild cognitive impairment, whereas an increase was observed in vascular dementia compared to Alzheimer's disease. Surface under the cumulative ranking curve and cluster analysis showed that the NfL concentration in CSF (vascular dementia, frontotemporal dementia, and Alzheimer's disease) and serum/plasma (frontotemporal dementia and Alzheimer's disease) ranked first among neurodegenerative dementia diseases. NfL is an important biomarker that can help clinical neurologists make early diagnoses of neurodegenerative diseases, so patients can receive prompt treatment.

摘要

神经丝轻链蛋白在神经退行性痴呆疾病中的诊断价值仍存在争议。本研究通过系统文献检索,确定了截至 2018 年 10 月进行的相关病例对照研究。对检测神经丝轻链蛋白(NfL)浓度在脑脊液和血清/血浆中对神经退行性痴呆患者的诊断性能的 42 项研究进行了传统和净荟萃分析。神经退行性痴呆患者的脑脊液和血清/血浆 NfL 水平显著升高。网络荟萃分析显示,轻度认知障碍患者的脑脊液 NfL 水平显著降低,而血管性痴呆患者的 NfL 水平与阿尔茨海默病相比则升高。累积排序曲线下面积和聚类分析表明,脑脊液中 NfL 浓度(血管性痴呆、额颞叶痴呆和阿尔茨海默病)和血清/血浆中 NfL 浓度(额颞叶痴呆和阿尔茨海默病)在神经退行性痴呆疾病中排名第一。NfL 是一种重要的生物标志物,可以帮助临床神经科医生对神经退行性疾病进行早期诊断,从而使患者能够得到及时治疗。

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