心型脂肪酸结合蛋白在胸痛6h内诊断急性心肌梗死的meta分析

heart-type fatty acid binding for diagnosis of acute myocardial infarction with chest pain within 6h:meta-analysis

目的采用meta分析的方法评价血清心型脂肪酸结合蛋白检测在胸痛发生6h内的急性心肌梗死诊断中的应用价值。方法通过计算机检索Medline、Pubmed、EMBASE、OVID、中国期刊全文数据库(CNKI)等,收集发表2006年1月至2013年1月的关于hFABP检测诊断AMI的横断面研究或病例对照研究,并应用Meta-DiSc统计软件进行分析。结果 7个研究,共2338例受试者纳入meta分析。结果显示血清hFABP检测诊断AMI的灵敏度为63%(95%CI:60%-66%),特异度为90%(95%CI:88%-91%),阳性似然比为4.48(95%CI:2.06-9.75),阴性似然比为0.42(95%CI:0.25-0.69),诊断比数比为10.97(95%CI:3.51-34.31),SROC曲线下的面积(the area under curve,AUC)为0.8859。结论 hFABP在胸痛发生6h内对AMI有较高的诊断效能,可作为临床上诊断AMI的有效方法。

Objective To evaluate the diagnostic value of heart-type fatty acid-binding protein （hFABP）for early de-tection of subjects entering the hospital with chest pain within 6h suggestive of acute myocardial infarction （AMI）by meta-analysis.Methods By searching Medline,Pubmed,EMBASE,OVID,CNKI et al datebase from January 2006 to January 2013,all the cross-sectional and case-control studies about hFABP in the diagnosis of AMI were collected to calculate the pooled results by using statistic software Meta-DiSc.Results seven trials with 2338 subjects were includ-ed in this meta-analysis.The pooled sensitivity（SEN）,specificity（SPE）,positive likelihood ratio（＋LR）,Negative like-lihood ratio（-LR）,diagnostic odds ratio（DOR）were 63%（95% CI：60%-66%）,90% （95% CI：88%-91%）,4.48 （95%CI：2.06-9.75）,0.42（95% CI：0.25-0.69）,10.97（95% CI：3.51-34.31）respectively.And the SROC AUC was 0.8859.Conclusion HFABP plays an excellent diagnostic performance of AMI within 6 h after symptom onset.