16S rRNA基因检测对新生儿败血症诊断价值的Meta分析

Meta-analysis of value of 16S rRNA gene detection in diagnosis of neonatal sepsis

目的 16S rRNA基因检测是诊断新生儿败血症的方法之一,但是尚无研究综合评价其诊断价值,本研究拟系统评价16S rRNA基因检测在新生儿败血症中的诊断价值。方法在Cochrane图书馆、Medline、Embase、Science Di-rect、中国期刊全文数据库、万方、维普等数据库中查找利用16S rRNA基因检测诊断新生儿败血症的文献。QUADAS工具评价纳入文献的质量,Meta-Disc 1.4软件检验异质性并根据其结果选择相应效应模型计算纳入研究的合并敏感性、特异性等指标,绘制汇总受试者工作特征(SROC)曲线,综合评价16S rRNA基因检测的诊断价值。结果共有8篇文献共计2 543例新生儿纳入本次研究,Meta分析显示16S rRNA基因检测对新生儿败血症的合并诊断价值分别为:敏感度为0.93,特异度为0.97,阳性似然比为25.12,阴性似然比为0.08,诊断比值比为323.40。SROC曲线下面积为0.99。结论 16S rRNA基因检测中对新生儿败血症具有较高的诊断价值,可作为诊断新生儿败血症重要工具。

Objective 16S rRNA gene detection is one of the methods for the diagnosis of neonatal sepsis,but there is not any study evaluating its diagnostic value comprehensively.So this study aims to evaluate the diagnostic value of 16S rRNA gene detection in neonatal sepsis comprehensively.Methods Literature on diagnosis of neonatal sepsis using the 16S rRNA gene detection was searched in Cochrane Library,Medline,Embase,Science Direct,CNKI,Wanfang,VIP and other databases.QUADAS tool was used to evaluate the quality of literature;Meta-Disc 1.4 software was used to test heterogeneity,based on which the relevant effect model was selected to calculate the combined sensitivity,specificity and other indicators of the literature,the summary receiver operating characteristic（SROC） curve was drawn and the diagnostic value of 16S rRNA gene detection was evaluated comprehensively.Results A total of 8 pieces of literature including 2 543 neonates were included in this study.Meta-analysis showed that the combined diagnostic value of 16S rRNA gene detection in neonatal sepsis was as follows： sensitivity was 0.93,specificity was 0.97,positive likelihood ratio was 25.12,negative likelihood ratio was 0.08,diagnostic ratio was 323.40.Area under the SROC curve was 0.99.Conclusion 16S rRNA gene detection has high diagnostic value in neonatal sepsis and therefore can be used as an important tool for the diagnosis of neonatal sepsis.