SINPHONI-2 Investigators (Appendix).; SINPHONI-2 Investigators Appendix
SINPHONI-2 Investigators (Appendix).; SINPHONI-2 Investigators Appendix
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SINPHONI-2 研究人员（附录）。；
DOI：
10.1111/ane.12580
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Mori E
中科院分区：
文献类型：
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作者：
Yamada S;Ishikawa M;Miyajima M;Atsuchi M;Kimura T;Kazui H;Mori E
目的：脑脊液穿刺试验对特发性正常压力脑积水（iNPH）的诊断敏感性低，但仍是分流治疗的良好预测指标之一。我们的目的是确定关键参数，可用于提高这种sensitivity.Materials & methodsDuring 2010-2011，我们招募，然后随访93例患者可能iNPH分流后12个月。其中，82例患者最终入组本研究。在入组时、穿刺试验后、分流术前后评价改良兰金量表、iNPH分级量表和几种定量测量。计算每次测量的受试者工作特征曲线下面积（AUC）、用于预测分流有效性的抽头试验的灵敏度和特异性。他们还进行了评估后，分层的疾病持续时间，因为最初的介绍iNPH symptoms.ResultsThe步态障碍的iNPH分级量表上有最高的准确度在自来水测试预测有效性分流后12个月：AUC 0.74，灵敏度56.5%，特异性91.7%。在病程<24、<12和<6个月的亚组中，该AUC分别增加至0.76、0.91和0.94。iNPH分级量表对分流术后12个月内步态障碍的敏感性和特异性分别为92.3%和90.0%。结论分流术后12个月内临床症状较短（如<12个月），使得叩击试验足以准确预测分流术后12个月的改善。研究结果表明，应尽快将抽头测试应用于考虑进行分流手术的患者。
ObjectivesThe cerebrospinal fluid tap test for idiopathic normal pressure hydrocephalus (iNPH) is one of the good predictors of the shunt treatment, although this test has a low sensitivity. We aimed to identify key parameters that could be used to improve this sensitivity.Materials & methodsDuring 2010–2011, we recruited and then followed 93 patients with possible iNPH for 12 months after shunt. Among them, 82 patients were finally enrolled in this study. The modified Rankin Scale, iNPH grading scale, and several quantitative measurements were evaluated at entry, after the tap test, before and after shunt. Area under the receiver‐operating characteristic curves (AUCs), sensitivities, and specificities of the tap test for predicting shunt effectiveness were calculated for each measurement. They were additionally assessed after stratification by disease duration since the initial presentation of iNPH symptoms.ResultsThe gait disturbance on the iNPH grading scale had the highest accurate scale at the tap test for predicting effectiveness 12 months after shunt: AUC 0.74, sensitivity 56.5%, specificity 91.7%. This AUC increased to 0.76, 0.91 and 0.94 in the subgroup of disease duration <24, <12, and <6 months, respectively. The sensitivity and specificity of the gait disturbance on the iNPH grading scale in the subgroup of <12 months' duration were 92.3% and 90.0%.ConclusionsThe shorter period of clinical symptoms, for example, <12 months, made the tap test sufficiently accurate examination for predicting improvement 12 months after shunt surgery. The findings imply that the tap test should be applied to patients being considered for shunt surgery as soon as possible.