摘要
目的评价早期白细胞计数(WBC)对急性百草枯中毒患者预后的预测价值。方法使用计算机检索国内外数据库中有关入院首次WBC与百草枯中毒预后的临床研究。中文文献数据库为中国知网(CNKI)、维普数据库、万方数据库、中国生物医学文献数据库(CBM),限制为核心期刊;外文文献数据库包括PubMed、Embase、Cochrane图书馆临床对照试验库;检索日期为自建库至2019年4月22日;语种不限。由2名研究者独立提取文献信息并使用Newcastle-Ottawa量表(NOS)对文献进行质量评价。使用Stata 15.0软件进行Meta分析,合并文献优势比(OR)、敏感度、特异度、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR)以及受试者工作特征曲线(SROC)下面积,从而评估早期WBC对急性百草枯中毒患者病死率的预测价值;采用Deeks漏斗图分析文献发表偏倚。结果最终纳入8篇文献共980例患者,其中7个回顾性研究,1个前瞻性研究;英文文献5篇,中文文献3篇;均为高质量文献。各研究间无异质性(I?2=43.5%,P>0.05),使用固定效应模型进行Meta分析显示,WBC可以预测百草枯中毒患者的预后〔OR=18.63,95%可信区间(95%CI)=13.63~25.48,P<0.001〕;合并研究的敏感度、特异度、PLR、NLR以及DOR分别为0.75(95%CI=0.66~0.82)、0.85(95%CI=0.80~0.90)、5.14(95%CI=3.86~6.86)、0.29(95%CI=0.22~0.39)、17.53(95%CI=12.23~25.13),SROC曲线下面积为0.88(95%CI=0.85~0.91)。Deeks漏斗图显示,各研究间无明显发表偏倚(P=0.21)。结论早期WBC对急性百草枯中毒患者预后具有一定的预测价值。
Objective To evaluate the prognostic value of early white blood cell count(WBC)in patient of acute paraquat poisoning.Methods The literatures about the studies on early WBC and prognosis after paraquat poisoning published in journals at home and abroad were searched.The Chinese literature database contained CNKI,VIP,Wanfang Database,and China Biomedicine Database(CBM),and the journals were limited to the core journals.The foreign language database included PubMed,Embase and Cochrane library clinical controlled trial database.The retrieval date was from the initial publication to April 22nd in 2019,without the limitation of languages.Two researchers independently extracted literature information,and the Newcastle-Ottawa Scale(NOS)was used to evaluate literature quality.The odds ratio(OR),sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),diagnostic odds ratio(DOR)and the area under the summary receiver operating characteristic(SROC)were combined and analyzed through the Stata 15.0 software to evaluate the predictive value of early WBC after acute paraquat poisoning.Publication bias was analyzed by Deeks funnel graph.Results There were 7 retrospective studies and 1 prospective study in a total of 980 paraquat poisoning patients,5 of them were English literatures,the others were Chinese literatures.There was no heterogeneity among the studies(I?2=43.5%,P>0.05).The OR and its 95%confidence interval(95%CI)of the literature was combined through the fixed effect model.The Meta-analysis results were statistically significant(OR=18.63,95%CI=13.63-25.48,P<0.001),suggesting that the WBC was significantly correlated with the mortality of patients.The combined sensitivity,specificity,PLR,NLR and DOR were 0.75(95%CI=0.66-0.82),0.85(95%CI=0.80-0.90),5.14(95%CI=3.86-6.86),0.29(95%CI=0.22-0.39),17.53(95%CI=12.23-25.13)respectively,and the area under the SROC of the WBC was 0.88(95%CI=0.85-0.91).Deeks funnel plot was symmetrical(P=0.21),and there was no obvious publication bias.Conclusion The early WBC has a certain predictive value for the prognosis of acute paraquat poisoning patients.
作者
李奕冰
张红华
张国秀
Li Yibing;Zhang Honghua;Zhang Guoxiu(Department of Emergency,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,China;Department of Emergency,the Second Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2019年第8期1013-1017,共5页
Chinese Critical Care Medicine
基金
河南省洛阳市科技计划项目(1001011A-5).
