脑脊液tau蛋白预测轻度认知障碍进展为阿尔茨海默病的Meta分析  

A Meta-analysis of Tau Protein in Cerebrospinal Fluid in Predicting Alzheimer's Disease

作　　者：蔡芳芳[1] 温仲民[1] 

机构地区：[1]苏州大学附属第二医院神经内科,215004

出　　处：《中国临床神经科学》2015年第4期411-417,共7页Chinese Journal of Clinical Neurosciences

摘　　要：目的评价脑脊液总tau（t-tau）蛋白和磷酸化tau（p-tau）蛋白预测轻度认知障碍（MCI）患者进展为阿尔茨海默病（AD）的临床价值。方法全面检索2000至2014年Pub Med、Cochrane Library、Web of Science数据库、Ovid全文电子期刊、中国知网全文数据（CNKI）和万方数据库中有关脑脊液tau蛋白预测MCI患者进展为AD的文献,收集每项研究中tau蛋白水平数据,用Stata11.0软件对数据进行Meta分析,计算合并效应量。采用Egger法对漏斗图作对称性检验评估发表偏倚、并进行敏感性分析。结果共纳入11项研究,其中9项研究完整提供了脑脊液总t-tau蛋白和p-tau蛋白浓度数据,另外2项研究仅提供了总t-tau蛋白浓度,未提供p-tau蛋白浓度。Meta分析显示：MCI进展为AD的患者脑脊液t-tau蛋白及p-tau蛋白基线浓度均高于稳定型MCI患者[t-tau：标准均数差（SMD）=1.063,95%CI：0.902~1.223,Z=13.00,P〈0.001;P-tau：SMD=1.335,,Z=7.44,P〈0.001]。结论脑脊液tau蛋白可作为预测MCI进展为AD的一项生物学指标。Aim To evaluate the level of tau protein in cerebrospinal fluid in predicting mild cognitive impairment patients progressing to Alzheimer＇s disease. Methods The published literature about predicting the conversion of mild cognitive impairment to Alzheimer＇s disease by cerebrospinal fluid tau protein was retrieved comprehensively in databases such as Pub Med, Cochrane Library, Web of Science. Data of tau protein were collected and analyzed by Meta-analysis by using Stata11.0. Publication bias was estimated by Egger＇s regression test and sensitivity analysis was made. Results Eleven studies met inclusion criteria, 9 of them provided complete CSF total tau protein and phosphorylated tau protein concentration data. The other two studies provided the total tau protein concentration only, did not provide the phosphorylated tau protein levels. The baseline concentrations of both t-tau and p-tau in MCI to AD patients were higherthan those in stable-MCI patients.（t-tau： SMD=1.063, 95%CI：0.902~1.223, Z=13.00, P〈0.001; p-tau： SMD=1.335, 95%CI：0.983~1.687, Z=7.44, P〈0.001）. Conclusion Tau protein in cerebrospinal fluid may be an important diagnostic biomarker for predicting the conversion from mild cognitive impairment to Alzheimer＇s disease.

关 键 词：脑脊液 t-tau蛋白 p-tau蛋白 轻度认知障碍 阿尔茨海默病 

分 类 号：R749.1[医药卫生—神经病学与精神病学]