中性粒细胞/淋巴细胞比值对骨科术后感染诊断价值的Meta分析  

Meta-analysis of the Diagnostic Value of Neutrophil/Lymphocyte Ratio in Orthopedic Postoperative Infection

作　　者：郑小龙 卿绍攀 严芳林 赖仕章 张锐 蒋成[2] ZHENG Xiao-long;QING Shao-pan;YAN Fang-lin;LAN Shi-zhang;ZHANG Rui;JIANG Cheng(Department of Clinical Medicine,North Sichuan Medical College,Nanchong 637000,Sichuan,China;Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院临床医学系,四川南充637000 [2]川北医学院附属医院骨科,四川南充637000

出　　处：《医学信息》2022年第6期101-106,共6页Journal of Medical Information

摘　　要：目的评价中性粒细胞/淋巴细胞比值(NLR)对骨科术后感染的诊断价值。方法对Cochrane Library、PubMed、EMbase、万方、CNKI、维普、CBM进行检索。搜集建库至2021年2月所有评价和探究NLR对骨科术后感染诊断价值的试验研究,导入EndNote X9筛选最终纳入文献并用QUADAS2评价文献质量,用Meta-Disc1.4和Stata 15.1分析数据。结果最终定量分析文献13篇,2636例研究对象,其中男性1275例,女性1361例。Meta结果显示:NLR诊断骨科术后感染汇总灵敏度为0.76,特异度为0.71,阳性似然比为3.28,阴性似然比为0.32,诊断比值比为11.94,综合受试者工作曲线(SROC)的曲线下面积(AUC)为0.85,Q*为0.78;单个因素Meta回归、亚组和敏感性分析发现研究结果变化小,稳定性较好,Deeks漏斗图提示无发表偏倚(P=0.80)。结论NLR对骨科患者术后感染的诊断具有一定的准确性,可作为骨科术后感染的诊断指标,有中等程度的准确性,但不能单独应用以排除或确诊骨科术后感染,可协同其他诊断指标以提高效能。Objective To evaluate the diagnostic value of neutrophil/lymphocyte ratio(NLR)for infection after orthopedic surgery.Methods Cochrane Library,PubMed,EMbase,Wanfang,CNKI,VIP and CBM were searched.All the experimental studies evaluating and exploring the diagnostic value of NLR for orthopedic postoperative infection from the establishment of the database to February 2021 were collected.EndNote X9 was imported to screen the final included literature and QUADAS2 was used to evaluate the quality of the literature.Meta-Disc1.4 and Stata 15.1 were used to analyze the data.Results Finally,13 articles and 2636 subjects were quantitatively analyzed,including 1275 males and 1361 females.Meta results showed that the total sensitivity of NLR in the diagnosis of orthopedic postoperative infection was 0.76,the specificity was 0.71,the positive likelihood ratio was 3.28,the negative likelihood ratio was 0.32,and the diagnostic ratio was 11.94.The area under the curve(AUC)of the comprehensive subject work curve(SROC)was 0.85,and Q*was 0.78.Single factor Meta-regression,subgroup analysis and sensitivity analysis showed that the results had little change and good stability.Deeks funnel plot showed no publication bias(P=0.80).Conclusion NLR has a certain accuracy in the diagnosis of postoperative infection in orthopedic patients,which can be used as a diagnostic index of postoperative infection in orthopedics,and has moderate accuracy.However,it cannot be used alone to exclude or diagnose postoperative infection in orthopedics,and can cooperate with other diagnostic indexes to improve efficiency.

关 键 词：中性粒细胞/淋巴细胞比值 术后感染 骨科手术 骨髓炎 

分 类 号：R738[医药卫生—肿瘤] R816.8[医药卫生—临床医学]