降钙素原诊断重症急性胰腺炎的系统评价

Systematic review of diagnosis of the severity of acute pancreatitis by procalcitonin

目的系统评价当前研究降钙素原(PCT)预测重症急性胰腺炎(SAP)的文献质量,PCT作为SAP诊断标志物的价值。方法制定检索策略及纳入和排除标准,系统检索MEDLINE、Pub Med、the Cochrane clinical trials register数据库收集潜在的文献,并根据诊断性研究质量评价工具(QUADAS)评估纳入文献的质量,提取数据,进行Meta分析。结果共检索到相关文献188篇,符合纳入标准的文献12篇。PCT预测SAP的合并灵敏度和特异度分别为72%和86%;诊断优势比(DOR)为14.9(95%CI=5.6～39.8),SROC曲线下面积为0.87。结论目前研究表明PCT对SAP进展有较好的预测价值。

Objective To systematically assess procalcitonin （PCT） as a predictor in the development of severe acute pancreatitis （SAP）. Methods MEDLINE,Pub Med,the Cochrane clinical trials register Database were searched systematically for prospective studies,which evaluated the usefulness of PCT as a marker of SAP when we made search strategy and inclusion or exclusion criteria. According to the Quality Assessment of studies of Diagnostic Accuracy included in Systematic reviews （QUADAS）, we assessed quality and draw available data about studies,then made a Mata-analysis. Results Twelve of 59 studies identified were included in data extraction. The sensitivity and specificity of PCT for development of SAP were 0.72 and 0.86, respectively [area under the curve （AUC）=0.87;DOR= 14.9;950~ confidence interval（CI） = 5.6-39.8]. Conclusion Serum measurements of PCT may be valuable in predicting SAP.