血清S-100B对轻型颅脑损伤诊断价值的系统评价和Meta分析

Serum S-100B for mild traumatic brain injury:a systematic review and meta-analysis of diagnostic test accuracy

目的系统评价血清学标志物S-100B对于轻型颅脑损伤(mTBI)患者颅内损伤的诊断价值。方法计算机检索PubMed、EMbase、The Cochrane Library、中国知网、中国生物医学数据库、维普、万方数据库,筛选S-100B预测mTBI后颅内损伤的诊断性试验,检索时限为自建库至2022年5月27日。由2名研究员根据纳入和排除标准筛选文献、数据提取,并采用QUADAS-2工具评价纳入研究的偏倚风险,采用Meta-DiSc 1.4软件分析血清S-100B对mTBI的诊断价值。结果共纳入21篇文献,包括8057例患者。Meta分析结果显示:S-100B诊断mTBI颅内损伤的诊断比值比为5.55(95%CI:3.47~8.87),合并灵敏度为0.91(95%CI:0.88~0.93),合并特异度为0.29(95%CI:0.28~0.30),合并阳性似然比为1.35(95%CI:1.25~1.47)、合并阴性似然比为0.26(95%CI:0.16~0.44)。S-100B诊断mTBI颅内损伤的综合受试者工作特征曲线的曲线下面积为0.760。结论S-100B对于mTBI患者颅内损伤有一定的诊断价值,可作为筛查工具辅助急诊医生进行筛查。

ObjectiveTo systematically evaluate the diagnostic value of S-100B for intracranial injury in patients with mild traumatic brain injury(mTBI).MethodsPubMed,EMbase,The Cochrane Library,CNKI,CBM,VIP and WanFang Data databases were searched by computer for diagnostic tests about S-100B as predictors of intracranial injury after mTBI from inception to May 27,2022.Two reviewers independently screened literature according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality of included studies by using the Quality Assessment of Diagnostic Accuracy Studies 2 tool,and the diagnostic value of serum S-100B for mTBI was analyzed by Meta-DiSc software(version 1.4).ResultsA total of 21 literature articels involving 8057 patients were included.Meta-analysis showed that diagnostic odds ratio pooled was 5.55(95%CI:3.47-8.87),pooled sensitivity was 0.91(95%CI:0.88-0.93),pooled specificity was 0.29(95%CI:0.28-0.30),pooled positive likelihood ratio was 1.35(95%CI:1.25-1.47),pooled negative likelihood ratio was 0.26(95%CI:0.16-0.44),and the area under curve of the comprehensive subject working characteristic curve of S-100B diagnosis for intracranial injury with mTBI was 0.760.ConclusionS-100B has good predictive value in the screening of intracranial injury among mTBI patients,and can be used as a screening tool for identification of traumatic intracranial lesions in patients with mild TBI.