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首页> 外文期刊>Journal of neurology >Impact of eerebro-spinal fluid biomarkers of Alzheimer's disease in clinical practice; a multicentric study
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Impact of eerebro-spinal fluid biomarkers of Alzheimer's disease in clinical practice; a multicentric study

机译：阿尔茨海默氏病脑脊髓液生物标志物在临床实践中的影响;多中心研究

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CSF biomarkers of Alzheimer's disease are well validated in clinical research; however, their pragmatic utility in daily practice is still unappreciated. These biomarkers are used in routine practice according to Health Authority Recommendations. In 604 consecutive patients explored for cognitive disorders, questionnaires were pro-spectively proposed and filled. Before and after CSF bio-marker results, clinicians provided a diagnosis and an estimate of their diagnostic confidence. Analysis has compared the frequency of diagnosis before and after CSF biomarker results using the net reclassification improvement (NRI) method. We have evaluated external validity comparing with data of French Bank National of AD (BNA). A total of 561 patients [Alzheimer's disease (AD), n = 253; non-AD, n = 308] were included (mean age, 68.6 years; women, 52 %). Clinically suspected diagnosis and CSF results were concordant in 65.2 % of cases. When clinical hypothesis and biological results were discordant, a reclassification occurred in favour of CSF biomarkers results in 76.9 %. The NRI was 39.5 %. In addition, the results show a statistically significant improvement in clinician confidence for their diagnosis. In comparison with BNA data, patients were younger and more frequently diagnosed with AD. Clinicians tend to heavily rely on the CSF AD biomarkers results and are more confident in their diagnoses using CSF AD biomarkers. Thus, these biomarkers appear as a key tool in clinical practice.
机译：阿尔茨海默氏病的CSF生物标志物在临床研究中得到了很好的验证;但是，它们在日常实践中的实用作用仍然不被人们所认识。根据卫生当局的建议，将这些生物标记物用于常规实践。在604位连续的认知障碍患者中，前瞻性地提出并填写了问卷。在CSF生物标志物检测结果之前和之后，临床医生会提供诊断并评估其诊断可信度。分析使用净重分类改进（NRI）方法比较了CSF生物标志物结果之前和之后的诊断频率。我们与法国国民银行（BNA）的数据进行了比较，评估了外部有效性。共有561名患者[阿尔茨海默氏病（AD），n = 253;非广告，n = 308]（平均年龄68.6岁;女性52％）。临床怀疑的诊断和脑脊液检查结果在65.2％的病例中一致。当临床假设和生物学结果不一致时，发生重分类，有利于CSF生物标志物的结果为76.9％。 NRI为39.5％。此外，结果显示临床医生对其诊断的信心在统计学上有显着提高。与BNA数据相比，患者更年轻，被诊断出AD的频率更高。临床医生倾向于严重依赖CSF AD生物标志物的结果，并且对使用CSF AD生物标志物的诊断更有信心。因此，这些生物标志物似乎是临床实践中的关键工具。

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