降钙素原检测早期诊断呼吸机相关性肺炎临床价值的Meta分析  

Meta analysis on the diagnostic value of procalcitonin in early ventilator-associated pneumonia

作　　者：杨夏慧[1] 阳隽[1] 陈晓军[1] 陈飞鹏[1] 

机构地区：[1]广州医科大学第二附属医院呼吸内科,510260

出　　处：《实用医学杂志》2015年第13期2186-2189,共4页The Journal of Practical Medicine

摘　　要：目的：通过分析已有的临床试验分析降钙素原检测对呼吸机相关性肺炎（VAP）的诊断价值。方法：用关键词途径对2000—2014年CNKI数据库、万方数据库、PubMed数据库进行文献检索，对符合条件的所有研究进行Meta分析。结果：共纳入13篇文献，样本量1137例，诊断VAP患者599例。异质性检验显示纳入研究齐J胜较好，通过汇总计算得出总敏感度为59％（43％～73％），总特异度为89％（82％-93％），总阳性预测值为3．69（3．21～4．23），总阴性预测值为0．42（0．32～0．55），合并受试者工作特征曲线（SROC）的曲线下面积为0．86。截断值为2．0μg／L时PCT诊断敏感度为81％（73％-87％），特异度为83％（73％-90％）。结论：降钙素原对呼吸机相关性肺炎早期诊断有一定的诊断价值。截断值2．0μg／L时试验的准确性和综合效能较高。Objective To evaluate the diagnostic value of procalcitonin in early ventilator-associated pneumonia. Methods CNKI database, Wanfang database and PubMed （2000-2014） were applied for document retrieval through keyword searching approach. Meta-analysis was used in all eligible studies. Results Thirteen studies were collected. The sample bank includes 1 137 cases, of which 599 cases were diagnosed as ventilator- associated pneumonia. Heterogeneity test showed that the homogeneity of the studies was good. The value of the weighted sensitivity was 59% （43% - 73%）, the specificity was 89% （82% ~ 93%）, the positive likelihood ratio was 3.69 （3.21 - 4.23）, the negative likelihood ratio was 0.42 （0.32 - 0.55）, and the SROC area under the curve （AUC） was 0.86. The value of the weighted sensitivity was 81%（73% - 87%）, the specificity was 83% （73% - 90% ）. Conclusion Procalcitonin can be regarded as a valuable marker in early ventilator- associated pneumonia diagnosis, when the cut-off point of PCT is 2.0 μg/L.

关 键 词：降钙素原 呼吸机相关性肺炎 荟萃分析 

分 类 号：R563.1[医药卫生—呼吸系统]