摘要
目的系统评价降钙素原(procalcitonin,PCT)对确诊败血症的诊断价值。方法用计算机检索MELINE、CNKI、VIP等数据库,以血培养阳性为纳入标准纳入国内外有关PCT诊断败血症的研究。采用QUADAS工具进行质量评价,利用Metadisc1.4计算各个研究的合并诊断优势比(diagnosic odd sratio,DOR)进行异质性分析,并计算敏感度、特异度、阳性似然比和阴性似然比,进行合并受试者诊断特征曲线(synthesis receiver operator characteristic cruve,SROC)分析,获得SROC曲线下面积(area under curve,AUC)。结果按照纳入标准,纳入国外13个研究,国内15个研究。纳入的28篇研究间存在较小的异质性(χ2=34.23,P=0.16,I2=21.1%);而国内15个研究和国外13个研究各自间不存在异质性(χ2=9.48,P=0.799,I2=0.0%和χ2=8.61,P=0.736,I2=0.0%)。28个研究合并敏感度和特异度分别为92.1%和80.6%,AUC为0.9518;有关新生儿的17研究其合并敏感度为92.8%,合并特异度为80.9%,AUC为0.9611。结论 PCT对败血症早期诊断有较高的价值,且在新生儿败血症早期诊断中的价值更高。
Objective To evaluate the diagnostic value of procalcitonin for early determination of sepsis.Methods Information concerning the use of procalcitonin for early detection of septicemia was collected from Pubmed,CNKI and VIP database.One standard was used in this study.The quality of the studies was assessed by using the QUADAS tool.Heterogeneity,sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and the area under the SROC（AUC）were analyzed by the software of Metadisc1.4 and Review Manager 5.Results According to the standard,15 domestic studies and 13 foreign reseaches were included in the analysis.There was no significant heterogeneity among these 15 domestic studies（χ2=9.48,P=0.799,I2=0.0%）and 13 foreign reseaches（χ2=8.61,P= 0.736,I2=0.0%）;but a little difference among the 28 studies（χ2=34.23,P=0.16,I2=21.1%）.In the 28 studies,the pooled sensitivity was 92.1%,pooled specificity was 80.6% and the area under the SROC was 0.9518.Moreover,reseaches about newborn performed in China and aboard showed high sensitivity（92.8%）,specificity（80.9%） and AUC（0.9611）.Conclusion In this systematic review,our results indicate good diagnostic performance of procalcitonin for diagnosing bacteremia,but higher predictive ability in diagnosing sepsis of newborn.
出处
《热带医学杂志》
CAS
2010年第12期1409-1414,共6页
Journal of Tropical Medicine
关键词
降钙素原
败血症
系统评价
血培养
procalcitonin
sepsis
systematic review
blood culture
