脑脊液降钙素原对颅内感染诊断价值的meta分析  

Meta analysis on diagnostic value of cerebrospinal fluid procalcitonin for intracranial infection

作　　者：刘涛 王鑫 裴文文 LIU Tao;WANG Xin;PEI Wenwen(Department of Clinical Laboratory,Yuncheng Municipal Central Hospital,Yuncheng,Shanxi 044000,China)

机构地区：[1]山西省运城市中心医院检验科,044000

出　　处：《重庆医学》2023年第14期2186-2191,2197,共7页Chongqing medicine

基　　金：山西省留学人员科技活动择优资助项目(2021049);山西省回国留学人员科研资助项目(2022-176)。

摘　　要：目的探讨脑脊液降钙素原(CSF-PCT)对患者颅内感染的诊断价值。方法检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方期刊数据库、中国临床试验注册中心、PubMed、Embase、Web of Science、Cochrane Library、ClinicalTrails中CSF-PCT对颅内感染诊断研究的文献,检索时间为建库至2021年7月。应用RevMan5.3提供的QUADAS-2风险评估工具对纳入文献进行质量评估,Meta-Disc1.4进行meta分析,Stata14.0判断发表偏移,绘制Deeks图。结果最终纳入15篇文献,共1224例患者。meta分析结果显示,总灵敏度0.77(95%CI:0.73~0.80)、特异度0.87(95%CI:0.84~0.89)、阳性似然比5.37(95%CI:4.09~7.05)、阴性似然比0.24(95%CI:0.16~0.34)、诊断比值比27.65(95%CI:15.41~49.61)、集成受试者工作特征曲线(SROC曲线)的曲线下面积(AUC)为0.9196,Q^(*)指数为0.8529。亚组分析结果显示,当CSF-PCT阈值设定为0.10~0.45 ng/mL时,研究间存在的异质性最小,结果更可靠。结论CSF-PCT对颅内感染患者有较高的灵敏度和特异度,可用于颅内感染的鉴别诊断。Objective To investigate the diagnostic value of cerebrospinal fluid procalcitonin(CSF-PCT)in the patients with intracranial infection.Methods The literatures about CSF-PCT on diagnosis of intracranial infection were retrieved from the databases of Chinese Biomedical Literature Database,CNKI,Wanfang Journal Database,VIP Chinese Science and Technology Journal Database,China Clinical Trial Registry,PubMed,Embase,Web of Science,Cochrane Library and ClinicalTrails.The retrieval time was from the establishment of the database to July 2021.The quality of included literatures was evaluated by the QUADAS-2 risk assessment tool provided by RevMan5.3 statistical software.The meta-Disc1.4 software was used for conducting the meta analysis,and the Stata14.0 software was used to judge the publication deviation and draw the Deeks diagram.Results A total of 15 articles and 1224 patients were finally included in the study.The meta analysis results showed that the total sensitivity was 0.77(95%CI:0.73-0.80),the specificity was 0.87(95%CI:0.84-0.89),the positive likelihood ratio was 5.37(95%CI:4.09-7.05),the negative likelihood ratio was 0.24(95%CI:0.16-0.34),the diagnostic odds ratio was 27.65(95%CI:15.41-49.61),the area under the summarized receiver operating characteristic(SROC)curve(AUC)was 0.9196 and the Q^(*)index was 0.8529.The subgroup analysis results showed that when the CSF-PCT threshold value was set as 0.10-0.45 ng/mL,the heterogenety existing between the studies was minimal and the results were more reliable.Conclusion CSF-PCT has high sensitivity and specificity to the patients with intracranial infection,and can be used for differential diagnosis of intracranial infection.

关 键 词：脑脊液 降钙素原 颅内感染 诊断 META分析 

分 类 号：R446.6[医药卫生—诊断学]