正五聚体蛋白3对脓毒症预后价值的Meta分析  

A meta-analysis of the prognostic value of pentraxin 3 for the patients with sepsis

作　　者：赵艳 张铁凝 刘春峰[1] Zhao Yan;Zhang Tiening;Liu Chunfeng(Department of Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿内科,沈阳110004

出　　处：《中国小儿急救医学》2022年第6期468-472,共5页Chinese Pediatric Emergency Medicine

基　　金：国家自然科学基金(81971810);辽宁省重大科技专项(2020JH1/10300001);沈阳市科技攻关项目(20-205-4-002)。

摘　　要：目的采用Meta分析方法评价正五聚体蛋白3(PTX3)水平对脓毒症患者的预后价值。方法检索PubMed、Cochrane Library、Embase、Web of Science、维普数据库、中国知网全文数据库、万方数据库及中国生物医学文献数据库,查找关于PTX3水平评估脓毒症患者预后情况的临床研究。检索时限从建库至2020年4月。根据纳入和排除标准进行筛选,纳入符合本Meta分析的临床研究。采用纽卡斯尔-渥太华量表对纳入文献质量进行评价。使用Review Manager 5.3软件进行Meta分析。结果共分析了来自9篇文献的1710例患者。与存活者相比,死亡者的PTX3水平显著升高:在随机效应模型中(I^(2)=95%,P<0.001),死亡者与存活者之间的合并标准化均数差为1.31(95%CI 0.73~1.90)。对其中6篇研究PTX3对脓毒症患者28 d病死率预测价值的文献进行合并分析,合并敏感度为0.799(95%CI 0.730~0.854),特异度为0.735(95%CI 0.649~0.807),诊断优势比为11.02(95%CI 6.60~18.40),合并阳性似然比为3.02(95%CI 2.24~4.06),合并阴性似然比为0.27(95%CI 0.20~0.37)。拟合受试者工作特征曲线下面积为0.83(95%CI 0.79~0.86)。结论PTX3对脓毒症具有良好的预后价值。Objective To investigate the prognostic value of pentraxin 3(PTX3)levels in patients with sepsis through meta-analysis.Methods Databases including PubMed,The Cochrane Library,Embase,Web of Science,China Science and Technology Journal Database(VIP),China National Knowledge Infrastructure(CNKI),Wanfang Data and China Biology Medicine disc(CBM)from inception to April 2020 were searched for clinical studies that reported the relationship between PTX3 levels and the prognosis of patients with sepsis.Literature selection was based on inclusion and exclusion criteria.The quality of the included studies was evaluated with Newcastal-Ottawa scale and the Meta-analysis was conducted with Review Manager 5.3 software.Results Ten studies with 1710 cases were included.Meta-analysis results showed that compared with survivors,PTX3 levels of non-survivors significantly increased(in the random effects model,I^(2)=95%,P<0.001),the combined standard mean difference between non-survivors and survivors was 1.31(95%CI 0.73-1.90).A combined analysis of six studies on the predictive value of PTX3 for 28-day mortality in patients with sepsis was carried out,and the pooled sensitivity was 0.799(95%CI 0.730-0.854),the pooled specificity was 0.735(95%CI 0.649-0.807),the pooled odds ratio was 11.02(95%CI 6.60-18.40),the pooled positive likelihood ratio was 3.02(95%CI 2.24-4.06),the pooled negative likelihood ratio was 0.27(95%CI 0.20-0.37),and the area under summary receiver operator characteristic was 0.83(95%CI 0.79-0.86).Conclusion PTX3 has a good prognostic value for sepsis.

关 键 词：正五聚体蛋白3 脓毒症 预后 META分析 

分 类 号：R459.7[医药卫生—急诊医学]