降钙素原和血浆可溶性髓样细胞触发受体1诊断呼吸机相关性肺炎的比较:Meta分析

发布时间：2018-04-29 05:11

本文选题：呼吸机相关性肺炎 + 可溶性髓样细胞触发受体　；参考：《中国呼吸与危重监护杂志》2015年01期

【摘要】：目的评价降钙素原(PCT)和血浆可溶性髓样细胞触发受体1(s TREM-1)对呼吸机相关性肺炎(VAP)的诊断价值。方法系统检索Pub Med、Ovid SP(EMBASE)、Cochrane Library、clinicaltrials.gov、EBSCO、CBM、CNKI和中国万方数据库,检索截止时间为2013年12月。使用QUADAS量表对纳入文献的质量进行评价。通过Meta-disc软件对PCT和s TREM-1诊断VAP的敏感性、特异性、阳性似然比、阴性似然比、诊断比值比分别进行合并,并计算sROC曲线下面积(AUC),两者AUC的比较使用Z检验,并根据贝叶斯理论计算相应的验后概率。结果最终31篇文献纳入研究,其中PCT文献20篇,s TREM-1文献11篇。合并后结果提示,PCT诊断VAP的敏感性和特异性分别为0.78和0.74,诊断比值比为15.21,AUC为0.868。s TREM-1诊断VAP敏感性和特异性为0.88和0.80,诊断比值比为30.28,AUC为0.919。两者AUC比较差异无统计学意义(P=0.25)。结论结合贝叶斯理论,s TREM-1与PCT相比对VAP的诊断有较高的价值,但是两者均无法作为单独的手段用于诊断或排除VAP。
[Abstract]:Objective to evaluate the diagnostic value of procalcitonin (PCT) and soluble myeloid cell trigger receptor (TREM-1) in patients with ventilator-associated pneumonia (VAP). Methods the Pub MedOvid Ovid EMBASEN Cochrane Library and Chinese Wanfang database were searched systematically. The search deadline was December 2013. QUADAS scale was used to evaluate the quality of the literature included. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic ratio of PCT and s TREM-1 in the diagnosis of VAP were combined by Meta-disc software, and the area under sROC curve was calculated. Z test was used to compare the two AUC. The corresponding posterior probability is calculated according to Bayesian theory. Results 31 articles were included in the study, including 20 articles of PCT and 11 articles of TREM-1. The results showed that the sensitivity and specificity of the diagnosis of VAP were 0.78 and 0.74, the diagnostic ratio was 15.21 TREM-1, the sensitivity and specificity of the diagnosis of VAP were 0.88 and 0.80, and the diagnostic ratio was 30.28 and 0.919 respectively. There was no significant difference in AUC between the two groups. Conclusion the combination of Bayesian theory and PCT has higher value in the diagnosis of VAP, but neither of them can be used as a separate method to diagnose or exclude VAP.
【作者单位】：遵义医学院附属医院呼吸二科;浙江大学医学院附属第二医院急诊医学科;
【基金】：贵州省科学技术基金(编号:209.001.072.19)
【分类号】：R563.1

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