纤维蛋白原联合D-二聚体对肺栓塞诊断价值的Meta分析  

Diagnostic value of fibrinogen and D-dimer for pulmonary embolism:A Meta-analysis

作　　者：邱霞[1,2] 韩文娟[1,2] 陈康康[1,2] 毛蕾[1,2] 李萍[3] 葛龙[1,4] 田金徽[1] 

机构地区：[1]兰州大学循证医学中心,甘肃兰州730000 [2]兰州大学第二临床医学院,甘肃兰州730000 [3]兰州大学药学院,甘肃兰州730000 [4]兰州大学第一临床医学院,甘肃兰州730000

出　　处：《国际检验医学杂志》2015年第16期2371-2374,共4页International Journal of Laboratory Medicine

摘　　要：目的：系统评价纤维蛋白原联合 D-二聚体在肺栓塞诊断中的临床价值。方法计算机检索 PubMed（1966-2014.7）、Embase（1980-2014.7）、Web of science（1980-2014.7）、中国生物医学文献数据库（CBM,1978-2014.7）、中国知网（CNKI,1979-2014.7）、维普数据库（VIP,1989-2014.7）、万方数据库（WF,1982-2014.7）。收集用纤维蛋白原联合 D-二聚体诊断肺栓塞的试验研究,依据 QUADAS 质量评价标准评价纳入研究的质量后,采用 Meta-Disc 软件（version1.4）进行 Meta 分析。结果最终纳入8篇研究。合计1015例受试者。Meta 分析结果显示：纤维蛋白原联合 D-二聚体诊断肺栓塞的合并特异度、灵敏度、阴性似然比、阳性似然比、诊断比值比和 ROC 曲线下面积分别0.63（0.58,0.67）,0.90（0.87,0.92）,0.14（0.07,0.27）,2.35（1.91,2.88）,18.99（12.08,29.85）,0.8597。结论纤维蛋白原联合 D-二聚体在肺栓塞诊断中具有中等特异度和较高的灵敏度,可作为临床筛查肺栓塞患者的有效措施之一。Objective To systemically evaluate the accuracy of fibrinogen（FIB）and D-dimer testing for diagnosing pulmonary embolism（PE）.Methods Systematic and comprehensive literature was searched in PubMed（1 966 to July 2014）,Embase（1 980 to July 2014）,Web of science（1 980 to July 2014）,CBM（1 978 to July 2014）,CNKI（1 979 to July 2014）,VIP（1 989 to July 2014）,WF （1 982 to July 2014）.The relative studies of FIB and D-dimer for PE were included.The quality assessment of diagnostic accuracy studies（QUADAS）items were used to assess the quality of the included studies.The Meta-Disc（version 1.4）software was used to analyze the data.Results A total of 8 studies were included.The results of Meta-analyses showed the pooled specificity,sensitivity, negative likelihood ratio,positive likelihood ratio,ROC value,and summary receiver operating characteristic curve of FIB and D-dimer were 0.63（0.58,0.67）,0.90（0.87,0.92）,0.14（0.07,0.27）,2.35 （1.91,2.88）,18.99（12.08,29.85）,0.859 7 respectively. Conclusion The FIB and D-dimer has a moderate specificity and higher sensitivity in the diagnosis of PE,which could be used as one of selecting tests of PE.

关 键 词：纤维蛋白原 D-二聚体 肺栓塞 META 分析 

分 类 号：R563.5[医药卫生—呼吸系统]