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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Cerebrospinal Fluid Biomarkers as Predictors of Shunt Response in Idiopathic Normal Pressure Hydrocephalus: A Systematic Review
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Cerebrospinal Fluid Biomarkers as Predictors of Shunt Response in Idiopathic Normal Pressure Hydrocephalus: A Systematic Review

机译：脑脊液生物标志物作为特发性正常压力脑脊分流反应的预测因子：系统评价

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Background: The widely accepted treatment for idiopathic normal-pressure hydrocephalus (iNPH) is a cerebrospinal fluid (CSF) diversion shunt procedure, to which approximately 80% of patients will respond. The purpose of this systematic review was to identify which CSF biomarkers have been investigated in predicting shunt responsiveness in iNPH patients, and to analyze the level of evidence for each. Methods: To find all relevant articles, a comprehensive search of Medline, Embase, and PsycINFO was conducted. Results: The literature search identified 344 unique citations, of which 13 studies satisfied the inclusion criteria and were analyzed in our review. These 13 studies reported on 37 unique biomarkers. Conclusions: The available studies suggest that there is evidence for the utility of CSF biomarkers in predicting shunt responsiveness in iNPH patients, though none have been shown to predict shunt response with both high sensitivity and specificity. We found that there is no available evidence for the use of Aβ38, Aβ40, Aβ43, APL1β25, APL1β27, APL1β28, sAPP, aAPPα, sAPPβ, TNF-α, MCP-1, sCD40L, sulfatide, MBP, L-PGDS, cystatin C, transthyretin, TGF-β2, or YKL-40 in predicting shunt response. There is minimal evidence for the use of TGF-β1, TBR-II, homocysteine, and interleukins (particularly IL-1β, IL-6, and IL-10). However, the available evidence suggests that these biomarkers warrant further investigation. Aβ42, tau, p-tau, NFL, and LRG have the greatest amount of evidence for their predictive value in determining shunt responsiveness in iNPH patients. Future research should be guided by, but not limited to, these biomarkers.
机译：背景：发作性正常压力脑积水（INOWH）的广泛接受的治疗是一种脑脊液（CSF）转移分流程序，约80％的患者将响应。该系统审查的目的是确定已经研究了哪些CSF生物标志物在患有INPH患者中预测分流反应性，并分析每个人的证据水平。方法：要查找所有相关文章，进行了全面搜索Medline，Embase和Psycinfo。结果：文献搜索确定了344个独特的引文，其中13项研究满足了纳入标准，并在我们的审核中进行了分析。这项13项研究报告了37个独特的生物标志物。结论：可用的研究表明，有证据表明CSF生物标志物在inph患者预测分流反应性方面的效用，尽管没有已经显示出具有高敏感性和特异性的分流反应。我们发现，使用Aβ38，Aβ40，Aβ43，APL1β25，APL1β27，APL1β28，SAPP，AAPPα，SAPPβ，TNF-α，MCP-1，SCD40L，硫酸化物，MBP，L-PGDS，胱抑素C. ，Transthyretin，TGF-β2或YKL-40预测分流反应。使用TGF-β1，TBR-II，同胶和白细胞介素（特别是IL-1β，IL-6和IL-10）存在最小的证据。但是，可用的证据表明，这些生物标志物需要进一步调查。 Aβ42，Tau，P-Tau，NFL和LRG具有最多的证据，以便在inph患者中确定分流反应性时的预测值。未来的研究应该被引导，但不限于这些生物标志物。

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