初诊外周血淋巴细胞绝对值对儿童慢性原发性免疫性血小板减少症诊断价值的meta分析  

Diagnostic value of absolute lymphocyte count for chronic primary immune thrombocytopenia in children:a meta analysis

作　　者：胡洋帆 陈先睿[1] 施惠宣 黄建琪[1] Hu Yangfan;Chen Xianrui;Shi Huixuan;Huang Jianqi(Department of Pediatrics, the First Affiliated Hospital of Xiamen University, Pediatric Key Laboratory of Xiamen, Institute of Pediatrics, School of Medicine,Xiamen University, Xiamen 361003, China)

机构地区：[1]厦门大学附属第一医院儿科,厦门市儿科重点实验室,厦门大学医学院儿童医学研究所,福建厦门361003

出　　处：《临床荟萃》2020年第6期492-497,共6页Clinical Focus

摘　　要：目的评价初诊外周血淋巴细胞绝对值(ALC)诊断儿童慢性原发性免疫性血小板减少症(ITP)的临床价值。方法计算机检PubMed、EMbase、Cochrane Library、中国知网、中国生物医学文献数据库、维普中文期刊数据库和万方数据库上的中英文相关的文献,检索时间均为建库至2020年2月。2名研究者独立提取资料数据和评价纳入文献,并进行文献偏倚风险评价。采用Meta-Disc 1.4软件进行Meta分析,计算合并灵敏度、特异度、阳性似然比、阴性似然比以及描绘综合受试者工作特征(SROC)曲线。结果最终纳入5篇研究,包括1301例患儿,合并灵敏度为0.70[95%CI(0.66,0.73)]、合并特异度为0.65[95%CI(0.60,0.69)]、合并阳性似然比为3.36[95%CI(1.57,7.19)]、合并阴性似然比为0.45[95%CI(0.34,0.60)]。SROC曲线下面积(AUC)为0.771,Q=0.711。回归分析显示未发现研究间异质性来源。结论初诊ALC对预测诊断儿童慢性ITP仅具有中等灵敏度及特异度,ALC对于预测儿童ITP慢性发展的临床价值仍有待进一步研究。Objective To evaluate the clinical value of absolute lymphocyte count(ALC)for chronic primary immune thrombocytopenia in children.Methods The PubMed,Embase,Cochrane Library,CNKI,China Biology Medicine disc(CBMdisc),VIP and Wanfang digital knowledge service platform were searched for relevant literatures published in both English and Chinese.The search time was from the establishment of the database to February 2020.Two researchers independently extracted data and evaluated the included literature.Risk assessment of literature bias was carried out.Meta Disc 1.4 software was used for meta analysis,and the combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and the summary receiver operating characteristic(SROC)curve were calculated.Results A total of five studies with 1301 children were included,in which the combined sensitivity,combined specificity,combined positive likelihood ratio,combined negative likelihood ratio and the area under the SROC curve(AUC)for the diagnosis of chronic primary immune thrombocytopenia in children were 0.70(95%CI[0.66,0.73]),0.65(95%CI[0.60,0.69]),3.36(95%CI[1.57,7.19]),0.45(95%CI[0.34,0.60])and 0.771,Q=0.711,respectively.Conclusion Initial ALC has only moderate sensitivity and specificity for predicting the diagnosis of chronic ITP in children,and the clinical value of ALC for predicting the development of chronic ITP in children remains further study.

关 键 词：血小板减少 外周血淋巴细胞绝对值 儿童 

分 类 号：R558.2[医药卫生—血液循环系统疾病]