nCD64对新生儿败血症早期诊断价值的Meta分析  

The early diagnostic performance of neutrophil-CD64 in neonatal sepsis:Meta analysis

作　　者：李宝辉[1] 赵光[1] 李冬晖[1] LI Bao-hui, ZHAO Guang,LI Dong-hui.(Deparment of Central Laboratory,the 150th Central Hospital of PLA,Luoyang,Henan 471031, China)

机构地区：[1]解放军150医院中心实验室,河南洛阳471031

出　　处：《实用医药杂志》2018年第5期400-403,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨中性粒细胞表面抗原CD64(n CD64)在新生儿败血症早期诊断中的应用价值。方法制定文献检索策略和纳入标准,应用Meta分析统计n CD64于新生儿败血症的诊断准确性数据。结果 (1)截至2018年1月12日,分析纳入14篇研究(1736名新生儿);(2)合并诊断结果如下:灵敏度-0.85(95%CI[0.82 0.87]),特异度-0.83(95%CI[0.81 0.86]),AUC-0.90(95%CI[0.88 0.93]),阳性后验率-80%,阴性后验率-11%;(3)研究间存在异质性,但不存在发表偏倚和阈值效应。经Meta回归分析发现败血症的诊断标准(菌培阳性败血症、菌培阳性/临床败血症)是异质性的重要来源,菌培阳性败血症组(灵敏度-0.92,特异度-0.86)的诊断精确是菌培阳性/临床败血症组(灵敏度-0.82,特异度-0.81)的3.12倍。结论 n CD64对新生儿(≤30 d)败血症的早期诊断(≤24 h)具有较高准确性。Objective To explore the early diagnostic performance of neutrophil-CD64（n CD64） in neonatal sepsis. Methods Retrieving strategy for Chinese periodical and foreign periodical databases and including criteria were conducted,and thus applying meta-analysis was used to pool the diagnostic estimates of n CD64 in neonatal sepsis. Results 1）Fifteen studies including 2091 neonates were included in this meta-analysis. 2）The overall pooled sensitivity,specificity,area under summary ROC,positive and negative posterior probability were 0.85（95%CI [0.82 0.87]）,0.83（95% CI [0.81 0.86]）,0.90（95% CI [0.88 0.93]）,80% and 11%,respectively. 3）There was high heterogeneity found in summary analysis,while no threshold effect and publication bias were detected. Mete regression expressed the diagnostic standard was the source of heterogeneity,and the diagnostic precision of document sepsis group（sensitivity-0.92,specificity-0.86） was 3.12 times that of document/clinical sepsis group（sensitivity-0.82,specificity-0.81）. Conclusion There is high accuracy of n CD64 in early diagnosis of neonatal sepsis.

关 键 词：新生儿败血症 CD64 META分析 

分 类 号：R722.131[医药卫生—儿科] R446.11[医药卫生—临床医学]