中性粒细胞CD64与C-反应蛋白联合检测诊断新生儿败血症敏感性和特异性的meta分析  

Meta-analysis for the evaluation of combined neutrophile CD64/CRP test on the diagnosis of neonatal sepsis

作　　者：蔡和平[1] 赵扬[2] 王卓[1] 高申[1] 

机构地区：[1]第二军医大学长海医院药学部,上海200433 [2]国家食品药品监督管理局高级研修学院,北京100073

出　　处：《世界临床药物》2014年第3期166-171,共6页World Clinical Drug

基　　金：第二军医大学长海医院"1255"基金--学科特色提升项目(No.CH125520400)

摘　　要：目的对国外已发表的高质量的中性粒细胞CD64与CRP联合或分别单独检测诊断新生儿败血症敏感性和特异性的临床研究文献进行综合定量meta分析,为临床及时诊断和抗菌药物合理使用提供检测依据。方法收集PubMed、Embase和Science Citation Index Expanded建库至2013年10月发表的有关中性粒细胞CD64与CRP联合检测及两者分别单独检测诊断新生儿败血症敏感性和特异性的文献,对检索到的原始文献进行质量评估,对符合要求的4篇文献研究结果进行meta分析,评估CD64与CRP联合检测和两者单独检测诊断新生儿败血症敏感性和特异性的优势比(OR),评价其敏感性和特异性。结果临床诊断阳性的总病例数547例,临床诊断阴性的总病例数108例。meta分析结果显示,联合检测与CD64单独检测的敏感性差异具有统计学意义[OR=1.58,95%CI(1.16,2.16),P=0.006],特异性差异无统计学意义;联合检测与CRP单独检测的敏感性差异具有统计学意义[OR=4.38,95%CI(2.04,9.44),P=0.0002],特异性差异无统计学意义.。结论 CD64联合检测CRP诊断新生儿败血症的敏感性优于两种指标单独检测。Objective To evaluate the joint detection of neutrophil CD64 and CRP for diagnosing neonatal sepsis to provide a reference on the rational use of antimicrobial agents in anti-infection therapy. Methods All published trials regarded to sensitivity and specificity of joint detection neutrophil CD64 and CRP for diagnosing neonatal sepsis was searched in PubMed, Embase and Science Citation Index from the time the data base being setup to Oct, 2013. A meta- analysis of 4 studies was performed. The odds radio （OR） for sensitivity and specificity of joint detection neutrophil CD64 and CRP for diagnosing neonatal sepsis was calculated. Results In clinical diagnosis positive 547 cases and clinical diagnosis negative 108 cases, there were significantly different sensitivity between joint detection of CD64 plus CRP and detection of CD64 alone [OR=1.58, 95%CI （1.16, 2.16）, P=0.006]. Also a significant difference in sensitivity was showed between joint detection of CD64 plus CRP and detection of CRP alone [OR=4.38, 95%CI （2.04, 9.44）, P=0.0002]. Conclusion For diagnosing neonatal sepsis in specificity, joint detection of neutrophil CD64 plus CRP is better than the detection of CD64 alone or CRP alone.

关 键 词：CD64 C反应蛋白 败血症 META 

分 类 号：R446.11[医药卫生—诊断学]