α-防御素对假体周围关节感染的诊断价值:meta分析

Diagnostic accuracy of alpha-defensin for periprosthetic joint infection: a meta-analysis

背景:目前α-防御素对假体周围关节感染的诊断价值不确定。目的:通过meta分析评价α-防御素对假体周围关节感染的诊断价值。方法:计算机检索PUBMED、EMBASE、Cochrane图书馆、中国知网(CNKI)和万方数据库等数据库,手工检索相关期刊及学位论文,检索年限均从建库至2017年10月,无语言限制。采用Meta-Disc1.4软件进行meta分析:计算合并敏感性、特异性、阳性似然比、阴性似然比和诊断比值比。结果:纳入6篇文献进行meta分析,共604例患者。α-防御素在诊断假体周围关节感染的合并敏感性为0.96(95%CI:0.92～0.99),合并特异性为0.97(95%CI:0.95～0.98),合并阳性似然比和阴性似然比分别为23.56(95%CI:14.58～38.08)和0.05(95%CI:0.02～0.12),SROC下面积为0.9908, Q值为0.9603,诊断比值比为552.65(95%CI:166.27～1836.93)。结论:在诊断假体周围关节感染中,α-防御素具有较高的敏感性和特异性,可作为诊断假体周围关节感染的一种辅助手段。

Background： The diagnostic accuracy of alpha-defensin for periprosthetic joint infection is uncertain. Objective：To evaluate the diagnostic value of alpha-defensin in periprosthetic joint infection through a meta-analysis. Methods： The databases of PUBMED, EMBASE, Cochrane library, CNKI and Wanfang Database were retrieved by computer, and relevant periodicals and dissertations were retrieved manually. Searching publications ranged from the inception of each database to October 2017, and there was no language restriction. Meta-Disc 1.4 software was used for calculation with the sensitivity, specificity, positive and negative likelihood ratio and diagnostic odds ratio. Results： Six articles were included in this meta-analysis,with a total of 604 patients. The pooled diagnostic sensitivity and specificity of alpha-defensin was 0.96（95%CI： 0.92-0.99）and 0.97（95%CI： 0.95-0.98）, respectively. The pooled positive and negative likelihood ratio was 23.56（95%CI： 14.58-38.08）and 0.05（95%CI： 0.02-0.12）, respectively. The area under the SROC was 0.9908, and Q index was 0.9603. The diagnostic odds ratio was 552.65（95%CI： 166.27-1836.93）. Conclusions： Alpha defensin has high sensitivity and specificity. It can be used as an auxiliary means for diagnosing periprosthetic joint infection.