降钙素原对新生儿败血症早期诊断价值的系统评价

A Systematic Review of Procalcitonin for Early Detection of Septicemia of Newborn

目的系统评价降钙素原(PCT)对新生儿败血症早期诊断价值。方法用计算机检索CNKI、VIP等数据库。按两个纳入标准分别纳入有关PCT诊断新生儿败血症的研究,采用QUADAS工具进行质量评价,利用Metadisc1.4计算各个研究的合并DOR,进行异质性分析,并计算敏感度、特异度、阳性似然比和阴性似然比,进行合并受试者诊断特征曲线(SROC)分析,获得SROC曲线下面积(AUC)。用ReviewManager5软件进行其它诊断试验评价指标的Meta分析。结果按照标准一,纳入8个研究;按照标准二,纳入7个研究。8个研究间不存在异质性(χ2=3.28,P=0.858,I2=0.0%)。8个研究合并敏感度为0.914,合并特异度为0.935,AUC为0.9783;7项研究间不存在异质性(χ2=3.24,P=0.779,I2=0.0%),合并敏感度为0.876,合并特异度为0.943,AUC为0.9578。结论从目前的研究看,PCT对新生儿败血症早期诊断有很高的价值,是很好的辅助诊断指标。

Objective To evaluate the diagnostic value of procalcitonin for early detection of septicemia of newborn. Methods Information concerning the use of procaleitonin for early detection of septicemia was collected from CNKI and VIP database. Two different standards were used in this study. The quality of the studies was assessed using the QUADAS tool. Heterogeneity, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and the area under the SROC （AUC） were analyzed by the software of Metadiscl.4 and Review Manager5. Results According to the Standard One, eight studies were included in the analysis and there was no significant difference among these 8 studies （x^2=3.28,P=0.858,I^2=0.0%）. In these eight studies, the pooled sensitivity was 0.914, pooled specificity was 0.935 and the area under the SROC was 0.9783. According to the Standard Two, seven studies were included in the analysis and there was no significant difference among these 7 studies （x^2=3.24,P=0.779,I^2=0.0%）. In these seven studies, the pooled sensitivity was 0.876, pooled specificity was 0.943, and the area under the SROC was 0.9578. Conclusion In this systematic review, the diagnostic value of the procalcitonin is high, and it can be a good indicator for the early diagnosis of the septicemia of newborn.