C反应蛋白在自发性细菌性腹膜炎中诊断价值的Meta分析

C-reactive protein on the diagnosis of spontaneous bacterial peritonitis:a Meta-analysis

目的系统评价外周血C反应蛋白(C-reactive protein,CRP)对自发性细菌性腹膜炎(spontaneous bacterial peritonitis,SBP)的诊断价值。方法计算机检索Pub Med、Embase、Web of Science、Cochrane Library、中国学术期刊(CNKI)全文数据库、维普(VIP)中文科技期刊全文数据库、中国生物医学文献数据库(CBM)和万方科技期刊全文数据库中关于CRP在SBP诊断价值的有关文献,检索时间从建库到2017年11月,并追查纳入文献的参考文献。由两名研究者按照纳入与排除标准独立筛选文献、提取资料、质量评价,采用QUADAS量表对纳入文献进行质量评估,对纳入文献使用Stata 14.0及Meta-Disc 1.4软件进行异质性检验并根据异质性结果选择相应的效应模型进行定量合成;计算敏感度、特异度及其95%CI,绘制汇总受试者工作特征曲线(SROC),并计算曲线下面积(AUC)及Q*指数。结果共纳入16篇文献,共计1 657例患者。分析结果显示:外周血CRP对SBP诊断的敏感度和特异度分别为0.80(95%CI:0.77~0.83)和0.73(95%CI:0.70~0.76),SROC的AUC=0.8542,Q*指数为0.7851。结论 CRP诊断肝硬化SBP的敏感度和特异度较高,对SBP的诊断有一定的帮助。

Objective To evaluate the diagnostic value of peripheral blood C-reactive protein（ CRP） in patients with spontaneous bacterial peritonitis（ SBP）. Methods Pub Med,Embase,Web of Science,Cochrane Library,CNKI full-text database,VIP Chinese Science and Technology Journals full-text database, CBM and Wanfang Sci-tech periodicals full-text database related literature on the diagnostic value of CRP in SBP were searched,retrieval time from building to Nov. 2017 and traced references incorporated into the literature. Two researchers independently screened the literature,extracted data and quality evaluation according to inclusion and exclusion criteria,and used QUADAS scale to assess the quality of the included documents,the heterogeneity test was carried out on the included literature by Stata14. 0 and the corresponding effect model was selected according to the heterogeneity results for quantitative synthesis.Calculate sensitivity,specificity,and 95% CI,draw summary receiver operating characteristic curve（ SROC）,and calculated the area under the curve（ AUC） and Q＊index. Results A total of 16 articles were included for a total of1 657 patients. Analysis results showed that the sensitivity and specificity of CRP in the diagnosis of SBP were 0. 80（ 95% CI： 0. 77-0. 83） and 0. 73（ 95% CI： 0. 70-0. 76）,respectively. AUC of SROC = 0. 8542,Q＊index was0. 7851. Conclusion The sensitivity and specificity of CRP in the diagnosis of SBP in cirrhosis are higher,which may be help for the diagnosis of SBP.