尿TIMP-2×IGFBP7在脓毒症相关性AKI中早期诊断价值的Meta分析  

Predictive value of urinary TIMP-2×IGFBP7 for sepsis acute kidney injury:a Meta-analysis

作　　者：向晓红 钟燕军 李金秀[1] Xiaohong Xiang;Yanjun Zhong;JinxiuLi(Department of Critical Care Medicine,the Second Xiangya Hospital,Central South University,Changsha 410000,China)

机构地区：[1]中南大学湘雅二医院重症医学科,长沙410000

出　　处：《中华重症医学电子杂志》2022年第3期240-247,共8页Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)

基　　金：湖南省自然科学基金项目(2021JJ40896);长沙市科技重大专项项目(kh2202008)。

摘　　要：目的采用Meta分析系统评价尿基质金属蛋白酶组织抑制剂-2(TIMP-2)×胰岛素样生长因子结合蛋白7(IGFBP7)在脓毒症相关性急性肾损伤(AKI)中的早期诊断价值。方法系统检索PubMed,Web of Science,Cochrane,Embase英文数据库以及中国知网、万方、维普、中国生物医学文献服务系统中文数据库,用RevMan5.3和Meta-Disc1.4软件进行数据处理和分析。结果共纳入6篇文献592例患者。2项研究来自欧美国家,4项来自中国。TIMP-2×IGFBP7早期预测脓毒症相关性AKI的合并敏感度、特异度、阳性似然比、阴性似然比和诊断比值比及其95%CI分别为0.82(0.76~0.87)、0.59(0.54~0.64)、3.11(1.47~6.56)、0.27(0.13~0.57)和12.92(4.23~39.41)。绘制综合受试者工作特征曲线(sROC)发现TIMP-2×IGFBP7诊断脓毒症相关性AKI的曲线下面积(AUC)为0.8497,Q*为0.7809。亚组分析显示,TIMP-2×IGFBP7在AKI 1期和中国人群中的诊断价值更高,AUC分别为0.9072和0.8920。结论TIMP-2×IGFBP7对于脓毒症相关性AKI尤其是AKI 1期及中国人群具有较好的早期诊断能力。Objective To investigate the predictive value of urinary TIMP-2×IGFBP7 for sepsis acute kidney injury(AKI)by the Meta-analysis.Methods The database of PubMed,Web of Science,Cochrane,Embase,CNKI,WanFang,VIP and CBM were searched.Data was analyzed by RevMan 5.3 and Meta-Disc 1.4.Results Six studies involving 592 patients were included.Among them,2 studies were from Western countries,while 4 studies were from China.Pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio with corresponding 95%confidence interval were 0.82(0.76-0.87),0.59(0.54-0.64),3.11(1.47-6.56),0.27(0.13-0.57)and 12.92(4.23-39.41),respectively.The area under the curve for summary receiver operating characteristic curves was 0.8497 with a Q*value of 0.7809.Subgroup analysis showed that the predictive accuracy of TIMP-2×IGFBP7 was higher in stage 1 AKI and Chinese population,with AUCs of 0.9072 and 0.8920,respectively.Conclusion Urinary TIMP-2×IGFBP7 is an early predictive marker for sepsis AKI,especially in stage 1 AKI and Chinese population.

关 键 词：基质金属蛋白酶组织抑制剂-2 胰岛素样生长因子结合蛋白7 脓毒症 急性肾损伤 

分 类 号：R692[医药卫生—泌尿科学] R459.7[医药卫生—外科学]