尿液TIMP-2×IGFBP-7对急性肾损伤的早期诊断价值:meta分析  

The value of urine TIMP-2×IGFBP-7 in the early diagnosis of acute kidney injury:a meta-analysis

作　　者：王珍珍[1,2] 郭腾飞[1,2] 吴婷婷 常永超[1,2] 王瑞丽 薛云[3] WANG Zhenzhen;GUO Tengfei;WU Tingting;CHANG Yongchao;WANG Ruili;XUE Yun(Clinical Medical College of Henan University of Science and Technology,Luoyang,Henan 471000,China;Department of Clinical Laboratory,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China;College of Medical Technology and Engineering,Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学临床医学院,河南洛阳471000 [2]河南科技大学第一附属医院检验科,河南洛阳471000 [3]河南科技大学医学技术与工程学院,河南洛阳471000

出　　处：《检验医学与临床》2020年第15期2122-2125,2129,共5页Laboratory Medicine and Clinic

基　　金：国家自然科学基金项目(U1704117、31302106)。

摘　　要：目的探讨尿液金属蛋白酶组织抑制因子2(TIMP-2)与胰岛素样生长因子结合蛋白7(IGFBP-7)的乘积(TIMP-2×IGFBP-7)对急性肾损伤的早期诊断价值。方法系统检索Cochane library、EMBASE、PubMed自建库以来至2018年6月18日发表的有关尿液TIMP-2×IGFBP-7检测对急性肾损伤诊断价值的文献,根据纳入标准提取文献,运用诊断精确性研究的质量评价2对纳入文献进行质量评价。通过亚组分析探究异质性产生的原因。结果该研究纳入11篇文献,共2655例患者。分析结果显示,总体灵敏度和特异度分别为0.76(95%CI:0.73~0.80)、0.56(95%CI:0.54~0.58),阳性似然比、阴性似然比、诊断比值比分别为2.12(95%CI:1.77~2.53)、0.32(95%CI:0.22~0.47)、8.88(95%CI:4.78~16.49)。受试者工作特征曲线下面积为0.8190(Q=0.7526)。亚组分析结果显示,患者来源及临界值的选择可能是导致异质性发生的主要原因。结论尿液TIMP-2×IGFBP-7可能是急性肾损伤早期诊断的可靠指标,但由于其异质性的存在,需要高质量、大样本的研究对其进行进一步的验证。Objective To investigate the value of the product of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor binding protein 7(TIMP-2×IGFBP-7)in the early diagnosis of acute kidney injury.Methods The literatures about the diagnostic value of urine TIMP-2×IGFBP-7 test for acute kidney injury published by Cochane library,EMBASE and PubMed from the establishment of the database to June 18,2018 were systematically searched.According to the inclusion criteria,the literatures were extracted and the quality of the literatures was evaluated by using QUADAS-2.The causes of heterogeneity were explored by subgroup analysis.Results In this study,11 literatures were included,with 2655 patients.The results showed that the combined sensitivity and specificity were 0.76(95%CI:0.73-0.80),0.56(95%CI:0.54-0.58),the positive likelihood ratio,the negative likelihood ratio and the diagnostic ratio were 2.12(95%CI:1.77-2.53),0.32(95%CI:0.22-0.47)and 8.88(95%CI:4.78-16.49),respectively.The area under the receiver operating characteristic curve was 0.8190(Q=0.7526).The results of subgroup analysis showed that the choice of patients′source and critical value may be the main cause of heterogeneity.Conclusion Urine TIMP-2×IGFBP-7 may be a reliable indicator for early diagnosis of acute renal injury,but due to its heterogeneity,it needs to be further verified by high-quality and large sample research.

关 键 词：急性肾损伤 金属蛋白酶组织抑制因子2 胰岛素样生长因子结合蛋白7 早期诊断 META分析 

分 类 号：R692[医药卫生—泌尿科学]