中性粒细胞CD64和C-反应蛋白诊断新生儿败血症的敏感性和特异性:meta分析  

Sensitivity and specificity of neutrophil CD64 and C-reactive protein for diagnosing neonatal sepsis:a meta-analysis

作　　者：蔡和平[1,2] 赵扬[3] 王卓[1] 

机构地区：[1]第二军医大学长海医院药学部,上海200433 [2]安徽省儿童医院药剂科,合肥230000 [3]国家食品药品监督管理局高级研修学院,北京100073

出　　处：《第二军医大学学报》2014年第10期1168-1171,共4页Academic Journal of Second Military Medical University

基　　金：第二军医大学长海医院"1255计划"项目(CH125520400)~~

摘　　要：目的对国内外已发表的高质量的有关中性粒细胞CD64和C-反应蛋白(CRP)诊断新生儿败血症敏感性和特异性的临床研究进行meta分析,为临床医生选择适当的诊断检测指标提供参考依据。方法收集PubMed数据库、EMBASE数据库和Science Citation Index Expanded数据库从建库至2013年10月15日之间发表的有关中性粒细胞CD64和CRP诊断新生儿败血症敏感性和特异性的文献,根据meta分析的要求对检索到的原始文献进行质量评估,对符合要求的所有文献研究结果进行meta分析,计算CD64与CRP诊断新生儿败血症敏感性和特异性的优势比(OR),评价两种检测指标的敏感性和特异性。结果符合纳入标准的文献共8篇,临床诊断阳性的总病例数578例,临床诊断阴性的总病例数854例。Meta分析结果显示CD64与CRP检测新生儿败血症的敏感性差异有统计学意义[OR=2.79,95%CI(1.59,4.92),P=0.000 4],而两者检测新生儿败血症的特异性差异无统计学意义[OR=0.81,95%CI(0.50,1.30),P=0.37]。结论在目前研究中,CD64诊断新生儿败血症的敏感性优于CRP,而两者诊断新生儿败血症的特异性无明显差异。Objective To conduct a meta-analysis on the sensitivity and specificity of neutrophil CD64 and C-reactive protein（CRP）for diagnosing neonatal sepsis by retrieving all the relevant high quality publications,so as to provide evidences for clinicians to select diagnosis indicators.Methods The publication about the sensitivity and specificity of neutrophil CD64 and CRP for diagnosing neonatal sepsis were searched in PubMed,EMBASE and Science Citation Index Expanded from the setup time to Oct.15,2013.All the trials were evaluated strictly and the included trials were analyzed by meta-analysis.The odds radio（OR）for the sensitivity and specificity of CD64 and CRP for diagnosing neonatal sepsis was calculated.Results Eight studies were included for analysis.Totally 578 cases were positive and 854 cases were negative according clinical diagnosis.Meta analysis showed that the sensitivity of CD64 for diagnosing neonatal sepsis was significantly higher than that of CRP（OR=2.79,95%CI[1.59,4.92],P=0.000 4）,while the specificities of CD64 and CRP for diagnosing neonatal sepsis had no significant difference（OR=0.81,95%CI[0.50,1.30],P=0.37）.Conclusion This meta-analysis shows that CD64 is more sensitive than CRP for diagnosing neonatal sepsis,but the specificities of CD64 and CRP are similar for diagnosing neonatal sepsis.

关 键 词：CD64 C-反应蛋白 新生儿 败血症 META分析 

分 类 号：R722.131[医药卫生—儿科]