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血清神经丝轻链作为心搏骤停后神经功能结局的预测标志物:一项荟萃分析。

Serum neurofilament light chain as a predictive marker of neurologic outcome after cardiac arrest: a meta-analysis.

机构信息

Emergency Deparment, Cangzhou Central Hospital, No.16 Xinhua Road, Yunhe Qu, Cangzhou City, 061000, China.

出版信息

BMC Cardiovasc Disord. 2023 Apr 15;23(1):193. doi: 10.1186/s12872-023-03220-z.

Abstract

OBJECTIVE

Recently, an increasing number of studies have suggested using serum neurofilament light (NfL) chain to predict the neurologic outcome after cardiac arrest. However, the predictive ability of this approach remains inconclusive. Meta-analysis was performed on related studies to assess the ability of serum NfL to predict the neurologic outcome after cardiac arrest.

MATERIALS AND METHODS

PubMed, ScienceDirect and Embase were systematically searched from the date of their inception until June 2022. Data were extracted to calculate the area under the receiver operating characteristic curve (AUC), the sensitivity, the specificity and the publication bias to evaluate the predictive power of serum NfL using Stata 14.0.

RESULTS

Nine studies were included in the present meta-analysis. Seven studies involving 1296 participants reported serum NfL 24 h post arrest for predicting the neurological outcome, and the AUC was 0.92 (77% sensitivity and 96% specificity). Seven studies involving 1020 participants reported serum NfL 48 h post arrest for predicting the neurological outcome, and the AUC was 0.94 (78% sensitivity and 98% specificity). Four studies involving 804 participants reported serum NfL 72 h post arrest for predicting the neurological outcome, and the AUC was 0.96 (90% sensitivity and 98% specificity). No significant publication bias was observed among the included studies.

CONCLUSION

The present meta-analysis results support the potential use of serum NfL as an early biomarker of neurologic outcome, especially 72 h post arrest.

摘要

目的

最近,越来越多的研究表明,使用血清神经丝轻链(NfL)预测心脏骤停后的神经结局。然而,这种方法的预测能力仍不确定。本研究对相关研究进行了荟萃分析,以评估血清 NfL 预测心脏骤停后神经结局的能力。

材料和方法

系统检索了 PubMed、ScienceDirect 和 Embase 自成立以来至 2022 年 6 月的相关研究。提取数据以计算受试者工作特征曲线下面积(AUC)、敏感性、特异性和发表偏倚,使用 Stata 14.0 评估血清 NfL 的预测能力。

结果

本荟萃分析纳入了 9 项研究。7 项研究涉及 1296 例患者,报告了心脏骤停后 24 小时血清 NfL 预测神经结局的情况,AUC 为 0.92(敏感性为 77%,特异性为 96%)。7 项研究涉及 1020 例患者,报告了心脏骤停后 48 小时血清 NfL 预测神经结局的情况,AUC 为 0.94(敏感性为 78%,特异性为 98%)。4 项研究涉及 804 例患者,报告了心脏骤停后 72 小时血清 NfL 预测神经结局的情况,AUC 为 0.96(敏感性为 90%,特异性为 98%)。纳入的研究均无明显发表偏倚。

结论

本荟萃分析结果支持血清 NfL 作为神经结局的早期生物标志物的潜在用途,尤其是在心脏骤停后 72 小时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63b9/10105388/fab38adf166a/12872_2023_3220_Fig1_HTML.jpg

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