摘要
目的：系统评价中性粒细胞 CD64在成人脓毒症诊断中的价值。方法检索被PubMed、EMBASE、ISI Web of Knowledge、Cochrane Library、中国生物医学文献数据库、中国知网、维普、万方等数据库收录的建库至2015年有关CD64诊断脓毒症的文献。使用诊断性试验质量评价工具对纳入文献进行质量评价。应用Meta-Disc 1．4和STATA 12．0软件进行荟萃分析，根据异质性检验采用随机效应模型和固定效应模型，计算总体诊断敏感度、特异度、阳性似然比、阴性似然比和诊断比值比（ OR）等指标。绘制综合受试者工作特征曲线（ SROC）并计算曲线下面积（ AUC）。结果最终纳入完全符合要求的研究24项，共计3198例患者。荟萃分析的结果显示，中性粒细胞CD64诊断成人脓毒症的敏感度为0．79[95％可信区间（CI），0．77～0．81），特异度为0．86（95％CI：0．84～0．88）；合并阳性似然比为7.40（95％CI：5．02～10．91），阴性似然比为0．15（95％CI：0．10～0．22）；合并诊断比值比为60．07（95％CI：29．19～123．60）。综合受试者工作特征（SROC）曲线下面积为0．95，Q倡值为0．88。结论 CD64在成人脓毒症诊断中具有较好的价值，但还需要多中心、大样本量的临床试验进行验证。
Objective To evaluate the application of neutrophil CD 64 in diagnosis of sepsis in adult patients.Methods Literature retrieval from PubMed, EMBASE, ISI Web of Knowledge, Cochrane Library, CBM, CNKI, CQVIP, Wanfang Data from the establishment of database to the year 2015 was conducted to identify all studies on CD 64 in diagnosis of sepsis .The quality of the literature was evaluated with the quality assessment of diagnostic accuracy studies （ QUADAS）.Meta-Disc 1.4 and STATA 12.0 were used for meta analysis . Fixed-effects or random-effects model was performed based on the heterogeneity.The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were calculated .Summary receiver operating characteristic curves （ SROC ） and area under the curve （AUC） were used to evaluate the diagnostic performance of CD 64 for sepsis.Results A total of 24 studies involving 3 198 patients were included for systemic review .The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of CD 64 for diagnosis of sepsis were 0.79 （95 %CI：0.77-0.81）, 0.86 （95 %CI：0.84-0.88）, 7.40 （95 %CI：5.02-10.91）, 0.15 （95 %CI：0.10-0.22） and 60.07 （95%CI： 29.19-123.60）, respectively.The area under SROC of CD64 in diagnosis of sepsis was 0.95, and the Q＊ value was 0.88.Conclusion CD64 can be used to diagnose sepsis in adult patients , but it needs to be further confirmed by large multicenter studies .
出处
《中华临床感染病杂志》
2015年第5期444-450,共7页
Chinese Journal of Clinical Infectious Diseases
