摘要
目的评价半胱氨酸蛋白酶抑制剂C对慢性肾脏病患者肾小球滤过功能的诊断价值。方法检索MEDLINE、EMBASE、Cochrane图书馆等数据库,检索时间为1966年至2013年6月,收集关于检测血清胱抑素C对肾小球滤过功能的诊断价值的研究文献并进行质量评价,采用Cochrane协作网提供的Rev Man 5.0软件进行异质性分析,Meta-Di Sc进行Meta分析并绘制综合受试者工作特征曲线。结果共检索到相关文献231篇,最终纳入14篇文献,研究观察对象2 169例。Meta分析结果显示,肾小球滤过率以80-90 m L/min为诊断截点,纳入的14篇半胱氨酸蛋白酶抑制剂C诊断价值研究间的异质性不明显（P=0.10,I2=35%）;合并优势比30.71（21.70,43.46）;诊断的敏感度0.873,特异度0.791;综合受试者工作特征曲线下面积0.922 6。合并5篇肾小球滤过率轻度减低组（60-90 m L/min）的结果显示,文献间无异质性（P=0.71,I2=0.0%）;合并优势比7.05（4.56,10.91）;诊断的敏感度0.813,特异度0.609,综合受试者工作特征曲线下面积0.822 6。结论半胱氨酸蛋白酶抑制剂C与肾小球滤过率有良好相关性,半胱氨酸蛋白酶抑制剂C对慢性肾脏病患者肾小球滤过率诊断有较高的敏感性和特异性;慢性肾脏病患者肾小球滤过率分期研究不多,仍需要高质量的研究文献进一步验证。
Objective To evaluate the diagnostic value of Cystatin C（Cys C） in glomerular filtration rate（GFR）of chronic kidney disease（CKD） patients. Methods We searched MEDLINE, EMBASE, the Cochrane Library and other databases（1966 to June 2013） to collect studies which evaluated the diagnostic value of Cys C in evaluating GFR in patients with CKD. The heterogeneity of included studies was tested by the Cochrane Collaboration ＇s software Rev Man 5.0. The Summary Receiver Operating Characteristic（SROC） curve and meta-analysis were performed by Meta-Di Sc. Results Total of 14 relevant articles were included in our review, with study subjects involving 2 169 patients. Meta-analysis showed that GFR（cut-off 80 -90 m L / min）, the Cys C heterogeneity among studies was high（P =0.10, I2=35%）, OR=30.71（21.70,43.46）; SEN=0.873, SPE=0.791; SAUC=0.922 6. Five of the studies which included various stages of GFR（ 60 - 90 m L / min） group of meta- analyses showed that Cys C had no heterogeneity[ P = 0.71,I2=0.0%,OR =7.05（4.56,10.91）, SEN =0.813,SPE =0.609,SAUC =0.822 6]. Conclusion There is significant correlation between GFR and Cys C. As for early CKD, Cys C has more sensitivity and specificity for estimation of GFR. Further high quality researches on various stage of CKD are still required.
出处
《循证医学》
CSCD
2014年第5期291-296,共6页
The Journal of Evidence-Based Medicine
