Zhang Jun, Wang Haili, Li Yuping, Zhang Hengzhu, Liu Xiaoguang, Zhu Lei, Dong Lun
Department of Clinical Medicine, Dalian Medical University, Dalian, Liaoning, China.
Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, China.
Neurol Sci. 2021 Feb;42(2):539-551. doi: 10.1007/s10072-020-05019-8. Epub 2021 Jan 3.
The purpose of this meta-analysis was to assess the diagnosis and prognostic value of plasma copeptin levels after traumatic brain injury (TBI).
The databases PubMed, Cochrane Library, OvidSP, Google Scholar, VIP, CNKI, and WFSD were systematically searched from the inception dates to May 9, 2020. The pooled analysis of relevant data was conducted by the RevMan 5.3 software. Subgroups analysis was performed to explore the impact of age, country, male ratio, follow-up time, and Glasgow coma score (GCS) on the pooled area under curve (AUC) values of assessment mortality.
A total of 17 studies involving 2654 participants were included in the current meta-analysis. The pooled results demonstrated that increased plasma copeptin levels were significantly associated with TBI [SMD, 2.44; 95%CI, 1.59 ~ 3.29; P < 0.00001] and also were significantly associated with mortality [SMD, 1.37; 95%CI, 1.16 ~ 1.58; P < 0.00001], and poor functional outcomes (PFO) [SMD, 1.44; 95%CI, 1.20 ~ 1.68; P < 0.00001] in patients with TBI. Furthermore, the copeptin had a significant value in diagnosing brain concussion [AUC, 0.90; 95%CI, 0.84 ~ 0.95; P < 0.00001] and predicting progressive hemorrhagic injury [AUC, 0.83; 95%CI, 0.80 ~ 0.87; P < 0.00001], acute traumatic coagulopathy [AUC, 0.84; 95%CI, 0.79 ~ 0.89; P < 0.00001], mortality [AUC, 0.89; 95%CI, 0.87 ~ 0.92; P < 0.00001], and PFO [AUC, 0.88; 95%CI, 0.84 ~ 0.92; P < 0.00001] in patients with TBI. The subgroup analysis findings suggested that the age, country, male ratio, follow-up time, and GCS were not obvious factors influencing the pooled AUC values of assessment mortality.
The authors indicate that the plasma copeptin is a potentially promising biomarker for TBI diagnosis and prognosis prediction.
本荟萃分析旨在评估创伤性脑损伤（TBI）后血浆 copeptin 水平的诊断及预后价值。
从各数据库建库起至 2020 年 5 月 9 日，对 PubMed、Cochrane 图书馆、OvidSP、谷歌学术、维普、中国知网和万方数据知识服务平台进行系统检索。采用 RevMan 5.3 软件对相关数据进行汇总分析。进行亚组分析以探讨年龄、国家、男性比例、随访时间和格拉斯哥昏迷评分（GCS）对评估死亡率的汇总曲线下面积（AUC）值的影响。
本荟萃分析共纳入 17 项研究，涉及 2654 名参与者。汇总结果表明，血浆 copeptin 水平升高与 TBI 显著相关[标准化均数差（SMD），2.44；95%置信区间（CI），1.59～3.29；P＜0.00001]，也与 TBI 患者的死亡率显著相关[SMD，1.37；95%CI，1.16～1.58；P＜0.00001]以及功能预后不良（PFO）显著相关[SMD，1.44；95%CI，1.20～1.68；P＜0.00001]。此外，copeptin 在诊断脑震荡[AUC，0.90；95%CI，0.84～0.95；P＜0.00001]、预测进行性出血性损伤[AUC，0.83；95%CI，0.80～0.87；P＜0.00001]、急性创伤性凝血病[AUC，0.84；95%CI，0.79～0.89；P＜0.00001]、死亡率[AUC，0.89；95%CI，0.87～0.92；P＜0.00001]及 PFO[AUC，0.88；95%CI，0.84～0.92；P＜0.00001]方面具有显著价值。亚组分析结果表明，年龄、国家、男性比例、随访时间和 GCS 并非影响评估死亡率汇总 AUC 值 的明显因素。
作者指出，血浆 copeptin 是一种对 TBI 诊断和预后预测具有潜在前景的生物标志物。
