摘要
目的系统评价降钙素原(procalcition,PCT)对结核性胸腔积液(tuberculous pleural effusion,TPE的诊断价值。方法检索数据库包括Pub Med、Medeline、EMbase、Ovid、The Cochrane Library、中国生物医学文献服务网、中国知网、万方数据库,检索时间从自建库至2018年10月。用质量评价工具(QUADAS-2)对纳入文献质量进行评价。采用Stata14软件对数据进行合并,进行亚组分析,绘制SROC曲线并计算曲线下面积。结果纳入12项研究,合并灵敏度为0.67 (95%CI 0.54～0.79)、合并特异度为0.82 (95%CI 0.74～0.79)、合并阳性似然比为3.85 (95%CI 2.22～6.70)、合并阴性似然比为0.39 (95%CI 0.25～0.62),合并诊断优势比9.78 (95%CI3.71～25.79),曲线下面积(AUC)=0.83 (0.80～0.86)。Deeks,漏斗图结果表示不存在发表偏倚。结论胸水中PCT对TPE有较高的诊断价值,当cut-off值>0.2 ng/mL时诊断的准确性更高;且PCT可以更好鉴别诊断结核性与非恶性胸腔积液。
Objective To systematically evaluate the diagnostic value of procalcitonin (PCT) in tuberculous pleural effusion. Methods We searched PubMed, Medeline, Embase, Ovid, The Cochrane Library, CBM (China Biology Medicine disc, CBMdisc), CNKI (China National Knowledge Internet), and Wanfang databases, from the inception of each database until October 2018. The quality of the literature was evaluated using a quality assessment tool called Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The data were pooled using Stata14 software and then subgroup analyzed, the summary receiver-operating characteristic (SROC) curves were plotted and the area under the curve (AUC) was calculated.Results Twelve studies were included. The pooled sensitivity (SENS) was 0.67(95%CI 0.54-0.79), the pooled specificity (SPEC) was 0.82(95%CI 0.74-0.79), the pooled positive likelihood ratio (PLR) was 3.85 (95% CI 2.22-6.70), the pooled negative likelihood ratio (NLR) was 0.39 (95% CI 0.25-0.62), the pooled diagnostic odds ratio (DOR) was 9.78 (95% CI 3.71-25.79), and AUC was 0.83 (0.80-0.86). The DeeK funnel plot showed publication unbiased. Conclusion The PCT in pleural effusion has a higher diagnostic value in TPE. The diagnostic accuracy is higher when the cut-off value is >0.2 ng/ml;and PCT can better differentiate tuberculous from non-malignant pleural effusion.
作者
解春林
黄韬
滕兆伟
卜俊晖
李梦舟
张璟
XIE Chun-lin;HUANG Tao;TENG Zhao-wei;BU Jun-hui;LI Meng-zhou;ZHANG Jing(Dept. of Thoracic Surgery,The First Affiliated Hospital of Kunming Medical University,Kunming Yunnan650032;Dept. of Orthopedics,The Sixth Affiliated Hospital of Kunming Medical University,Yuxi Yunnan653100,China)
出处
《昆明医科大学学报》
CAS
2019年第4期91-96,共6页
Journal of Kunming Medical University
基金
云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2017FE467)
